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AT A G L A N C E
Original Medicare vs.
Medicare Advantage
Doctor and hospital choice
Original Medicare Medicare Advantage
You can go to any doctor that In most cases, you’ll need to use
accepts Medicare. doctors who are in the plan’s
network (for non-emergency or
non-urgent care). Ask your doctor
if they participate in any Medicare
Advantage Plans.
In most cases you don’t need a You may need to get a referral to see
referral to see a specialist. a specialist.
Cost
Original Medicare Medicare Advantage
For Part B-covered services, you Out-of-pocket costs vary—some
usually pay 20% of the Medicare- plans have low or no out-of-pocket
approved amount after you meet costs.
your deductible.
You pay a premium (monthly You may pay a premium for the
payment) for Part B. If you choose to plan (most include prescription
buy prescription drug coverage, you’ll drug coverage) and a premium
pay that premium separately. for Part B. Some plans have a $0
premium or will help pay all or part of
your Part B premium.
There’s no yearly limit on what you Plans have a yearly limit on what
pay out-of-pocket. you pay out-of-pocket for Medicare
Part A and B covered services. Once
you reach your plan’s limit, you’ll
pay nothing for Part A- and Part B-
covered services for the rest of the
year.
You can buy supplemental coverage You can’t buy or use separate
to help pay your out-of-pocket costs supplemental coverage—but some
(like your deductible and plans have lower out-of-pocket costs
20% coinsurance). than Original Medicare.
