Original Medicare vs. Medicare Advantage

You can go to any doctor that accepts Medicare

• In most cases, you’ll need to use 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 referral to see a specialist.
• You may need to get a referral to see a specialist
• For Part B-covered services, you usually pay 20% of the Medicare approved
• amount after you meet your deductible.
• Out-of-pocket costs vary—some plans have low or no out-of-pocket costs

Original Medicare vs Medicare Advantage

• You pay a premium (monthly payment) for Part B. If you choose to
• buy prescription drug coverage, you’ll pay that premium separately.
• You may pay a premium for the plan (most include prescription
• drug coverage) and a premium 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 pay out-of-pocket.
• Plans have a yearly limit on what 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 Bcovered services for the rest of the
• year.
• You can buy supplemental coverage to help pay your out-of-pocket costs
• (like your deductible and 20% coinsurance). You can’t buy or use separate
• supplemental coverage—but some plans have lower out-of-pocket costs
• than Original Medicare