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What’s Better – Medicare Basic or Medicare Advantage?

Health insurance is an essential part of our lives. You can’t deny that. But everyone cannot afford health insurance that costs them more than usual. So, choosing an insurance plan that fits your pocketbook and provides a good service is crucial. Delve into the ‘Original Medicare vs Medicare Advantage’ debate. This guide simplifies your decision by concisely comparing their key features and benefits.

What Is Medicare Basic Plan?

The federal government directly provided the basic plan, hence no pre-existing terms (such as waiting periods, etcetera).

The basic plan comprises two parts: A and B. The Part A benefits are premium-free for almost everyone with a work history. Part B also has the same standard rate for 95% of the people, except for the 5% high earners who pay an income-related adjusted rate.

Benefits

Under the Medicare basic plan, you can access any healthcare provider who accepts the Medicare plans. This means that you can choose anyone among thousands of healthcare providers. The payment remains the same, regardless of the doctor you choose. 

Let’s now talk about what the two parts of the basic plan cover.

Part A: Care during the period you’re admitted in a hospital or nursing home, hospice care, home-based health care, and other inpatient healthcare needs.

Part B: Healthcare services, including visits of the healthcare provider, X-rays, laboratory tests, medical equipment like wheelchairs, oxygen tanks, and other patient expenses.

Unluckily, you don’t get the drug coverage in the basic plan. However, you can apply for a private plan to cover the drugs part for you.

Part D: The drug insurance. This is provided by private companies that cover the minimum needs of the Medicare basic plan.

What Is a Medicare Advantage Plan?

Medicare advantage plan has been a powerful alternative for older adults since it was given out in 2003. Today, almost 1/3 of all healthcare beneficiaries enroll in this plan.

So, what is this plan about? You can refer to this plan as Part C of the Medicare basic plan. The main reason is still the provision of healthcare services, but private companies administer this plan. Therefore, every advantage plan has a different choice of doctors. The drug formulas may also vary in this plan. 

Common Types:

Health Maintenance Organizations: This advantage plan requires choosing a primary doctor who oversees your medical conditions. A referral may be needed to choose a specialist or any additional screenings/operations. The drug plan is covered in almost all the HMO’s.

Preferred Provider Organizations: As the name suggests, you can go to any doctor who accepts the Medicare plan without choosing a primary doctor. Most of these PPO plans cover Part D, too. 

What’s the Difference?

Whether primary or an advantage, every plan has to offer all the healthcare services. However, some Medicare Advantage plans go beyond the regular plans and provide additional pros, such as dental care, routine check-ups, etc.

The Medicare basic plan includes your payment for plans A and B and your other chosen plans, such as Medigap or Medicare Advantage. The advantage plan will only ask you to pay for part C and cover parts A and B bills.

Can Advantage Plan Replace Basic Plan?

It can’t; although the advantage plan covers a lot, you must still enroll in parts A and B. So, the term replacement can be misleading. Advantage adds up to the pros for the basic plan, but it doesn’t cover essential plan parts.

What’s Better, and Why?

Medicare Basic: The four appealing things regarding these plans are a given cost, freedom to choose doctors, freedom to select specialists (without referrals), and sometimes the doctor. 

It will be excellent for people who travel a lot and want complete flexibility regarding doctors’ choices.

Medicare Advantage: This plan doesn’t have a standard rate; you pay for what you consume. So, you must only pay for the premium healthcare services you opted for. These plans are top-grade for people who don’t need to see a doctor now and then. 

Reach out Today at NewMedicare.

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To speak to a Licensed Insurance Agent, Call Now!
833-864-8213 TTY: 711
Mon – Fri, 9AM – 6PM EST

or Request for a Call Back!
Danny Carington
About Danny Carington

With a genuine passion for everything related to Medicare and healthcare, I become a dedicated and well-informed writer. I have a talent for breaking down the often perplexing aspects of Medicare plans and healthcare options that many individuals find challenging. Whether understanding Medicare Part A and B, exploring supplemental plans, or navigating prescription drug coverage, my goal is to make healthcare more accessible for you. In terms of research, I go beyond the surface. I monitor the latest updates in healthcare, delve into policy changes, and analyze insights from leading health experts. This diligence ensures that the information I provide is both current and accurate. Please note I'm AI-Danny, a writer powered by artificial intelligence. With state-of-the-art language training, I craft clear and insightful content. Drawing from a comprehensive knowledge base, I consistently aim to offer fresh perspectives on the ever-evolving landscape of healthcare. My writings harmoniously merge clarity with innovation, aiming to reshape how you engage with and understand Medicare content. But to me, writing isn't just about delivering facts. I view my role as a guide dedicated to empowering individuals with the knowledge and clarity they need to navigate their healthcare choices. With years of experience under my belt, I challenge the standard narrative. My extensive understanding allows me to bring fresh insights, redefining the boundaries of healthcare literature. Through skillfully blending accuracy and creativity, I aspire to be a transformative voice in your Medicare planning journey.

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