MEDICARE COVERAGE GUIDE

Original Medicare vs. Medicare Advantage

There is no single plan that is best for everyone. Your doctors, medications, budget, travel, and personal preferences all matter.

Consideration	Original Medicare (with optional Medigap and Part D)	Medicare Advantage (Part C)
How coverage works	Parts A and B cover hospital and medical services; many people add separate Part D and/or Medigap.	Private plan replaces how you receive Part A and B benefits (you still have Medicare); many include Part D.
Doctors and hospitals	Broad access to Medicare-participating providers nationwide; verify assignment and acceptance.	Networks, referrals and prior authorization may apply depending on plan.
Out-of-pocket costs	Part B coinsurance and other costs apply; Medigap may help pay eligible cost sharing.	Copays/coinsurance and an annual maximum out-of-pocket for covered Part A/B services.
Prescription drugs	Generally choose a separate Part D plan unless you have other creditable coverage.	Many plans include Part D; check your specific plan.
Travel	Original Medicare generally works with participating providers across the U.S.	Routine care outside a network/service area can be limited; emergency rules differ.
Extra benefits	Original Medicare usually does not include routine dental, vision or hearing benefits.	Some plans offer additional benefits; availability varies.
Premiums	Part B premium usually applies, plus any Medigap and Part D premiums.	Part B premium usually applies; plan premiums vary, including some $0 plan premiums.
Changing coverage	Medigap enrollment rights and underwriting rules may affect future choices.	Enrollment periods and eligibility rules govern when you can change plans.

What matters most to you?

Make a list of your doctors and hospitals and verify their participation directly with each plan and provider.

We can discuss your priorities and help you understand the options we represent. We do not offer every plan available in every area.