Medicare Advantage vs. Original Medicare: What You Need to Know

Choosing between Original Medicare and Medicare Advantage is a pivotal decision as you approach retirement. At Silver Crest Insurance, we are committed to helping you understand your options and make an informed choice based on your health care needs and financial goals.

Understanding Original Medicare

Original Medicare is the traditional government program and includes two main parts:

• Part A (Hospital Insurance): Covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care.

• Part B (Medical Insurance): Covers outpatient care, doctor visits, preventive services, and some home health care.

Key Features:

• Provider Flexibility: You can visit any doctor or hospital in the U.S. that accepts Medicare.

• No Network Restrictions: No referrals are needed to see specialists.

• Separate Drug Coverage: Prescription drug coverage (Part D) must be purchased separately.

• Supplemental Coverage: You can buy a Medigap policy to help with out-of-pocket expenses like deductibles and coinsurance.

Things to Consider:

• Out-of-Pocket Costs: You typically pay 20% of the Medicare-approved amount for services after meeting the deductible.

• No Spending Cap: There’s no annual limit on your out-of-pocket expenses unless you add a Medigap policy.

Exploring Medicare Advantage (Part C)

Medicare Advantage plans are offered by private insurance companies approved by Medicare. These plans combine Part A and Part B coverage and often include additional benefits.

Key Features:

• All-in-One Coverage: Combines hospital, medical, and often prescription drug coverage.

• Additional Benefits: Many plans include dental, vision, hearing, and wellness programs.

• Cost Management: Medicare Advantage plans set a yearly limit on out-of-pocket costs for covered services.

Things to Consider:

• Network Restrictions: You may need to use doctors and hospitals within the plan’s network.

• Referrals and Authorizations: Some plans require referrals to see specialists and prior authorizations for certain services.

• Plan Variability: Coverage and costs can change annually, so it’s important to review your plan each year.

Medicare Advantage vs. Original Medicare: Quick Comparison

Feature	Original Medicare	Medicare Advantage
Provider Choice	Any Medicare-approved provider	Limited to plan’s network
Referrals Needed	No	Often required
Prescription Coverage	Separate Part D plan needed	Usually included
Extra Benefits (Dental, Vision)	Not included	Often included
Out-of-Pocket Maximum	None (unless with Medigap)	Yes, annual limit
Travel Flexibility	U.S. coverage only	Varies by plan

How to Choose the Right Plan for You

When deciding between Medicare Advantage and Original Medicare, ask yourself:

• Do you need the flexibility to see any doctor?

• Are you concerned about out-of-pocket costs?

• Do you want coverage for dental, vision, and hearing?

• Do you travel frequently or live in multiple states?

Choosing the right Medicare coverage depends on your health needs, lifestyle, and financial situation.

Let Silver Crest Insurance Help

At Silver Crest Insurance, we specialize in helping you navigate Medicare with confidence. Our expert agents can:

• Review your healthcare needs and preferences

• Compare available Medicare plans in your area

• Help you enroll smoothly and easily

• Provide ongoing support year after year

Contact Silver Crest Insurance today to schedule a personalized consultation. Let us help you find the Medicare solution that’s right for you!