Medicare Advantage vs. Original Medicare: A Clear Comparison

Think of your Medicare choice like choosing between an a la carte menu and a prix-fixe meal. Original Medicare is the a la carte option; it provides a solid foundation with Part A for hospital care and Part B for medical services. From there, you can add other “dishes” like a separate Part D plan for prescriptions and a Medigap policy to cover out-of-pocket costs. Medicare Advantage, on the other hand, is the prix-fixe meal. It bundles everything—Parts A, B, and usually D—into one convenient package, often with extra perks like dental and vision coverage included. The Medicare Advantage vs Medicare decision is about which style of “dining” best fits your lifestyle and budget.

Key Takeaways

Provider Choice is a Key Divider: Your choice depends on whether you value the freedom to see any doctor in the U.S. that accepts Medicare (Original Medicare) or prefer the all-in-one convenience and coordinated care of a local provider network (Medicare Advantage).
Compare Financial Safety Nets: Think about your budget and comfort with risk. Original Medicare has no yearly cap on your 20% coinsurance, while every Medicare Advantage plan has a firm out-of-pocket maximum that protects you from unlimited medical bills in a tough year.
Account for All Your Health Needs: Consider if you need routine dental, vision, hearing, or prescription drug coverage. Medicare Advantage plans often bundle these benefits, whereas with Original Medicare, you must purchase separate, standalone plans to get this coverage.

What is Original Medicare?

Think of Original Medicare as the foundational health plan offered by the federal government. It’s a great starting point for your healthcare coverage after you turn 65. This plan is made up of two main parts: Part A for hospital insurance and Part B for medical insurance. Together, they cover a wide range of essential healthcare services. One of the biggest draws of Original Medicare is its flexibility. You have the freedom to see any doctor or visit any hospital in the country that accepts Medicare, which gives you a lot of control over your healthcare decisions.

However, it’s important to know that Original Medicare doesn’t cover everything. For instance, it typically doesn’t include prescription drug coverage, so you’ll need to sign up for a separate Part D plan for your medications. It also doesn’t cover things like routine dental, vision, or hearing care. Because there’s no yearly limit on what you might pay out-of-pocket for your share of the costs, many people choose to pair Original Medicare with a Medicare Supplement plan, also known as Medigap, to help cover those remaining expenses. This combination provides comprehensive coverage and peace of mind.

What Parts A & B Cover

Let’s break down the two parts of Original Medicare. Part A is your hospital insurance. It’s there to help pay for your care if you’re admitted to a hospital or a skilled nursing facility. It also helps cover hospice care and some home health care services. For most people, Part A is premium-free because they or their spouse paid Medicare taxes while working.

Part B is your medical insurance. This part helps pay for the services you need to stay healthy, like doctor visits, outpatient hospital care, and preventive services such as flu shots. It also covers durable medical equipment like walkers or wheelchairs and a wide range of other medical supplies. Understanding what Parts A and B cover is the first step in figuring out if this is the right path for you.

What You Can Expect to Pay

With Original Medicare, you’ll have some regular costs. Most people pay a monthly premium for Part B. After you’ve paid your annual Part B deductible, you’ll typically be responsible for 20% of the cost for most doctor services, outpatient therapy, and medical equipment. This 20% is called coinsurance.

A crucial point to understand is that Original Medicare has no yearly limit on your out-of-pocket costs. This means that if you face a serious health issue, your 20% share could add up quickly. This is why many people purchase a Medigap policy to help cover these coinsurance costs and provide a safety net. You can find more details on the choice between Original Medicare and Medicare Advantage to see how these costs compare.

Choosing Your Doctors and Hospitals

One of the most valued features of Original Medicare is the freedom it offers. You can go to any doctor, specialist, or hospital in the United States as long as they accept Medicare. This nationwide network gives you incredible flexibility, whether you’re at home or traveling.

You also generally don’t need a referral from a primary care physician to see a specialist. If you need to see a cardiologist or a dermatologist, you can simply make an appointment. This direct access to specialists can save you time and give you more control over your healthcare journey. This freedom to choose your providers is a significant reason why many people stick with Original Medicare.

How is Medicare Advantage Different?

If you think of Original Medicare as the standard, government-provided path, Medicare Advantage is an alternative route. These plans, also known as Part C, are offered by private insurance companies that are approved by Medicare. They provide a different way to get your Medicare benefits, often with a different structure for costs, rules, and extra perks. Think of it as bundling your coverage into one convenient package. Instead of getting your benefits directly from the federal government, a private insurer manages your care. This structure is the foundation for all the other differences you’ll see, from costs and provider choices to the extra benefits that many plans include. Let’s walk through the key features that set these plans apart.

The Basics of Medicare Advantage Plans

Medicare Advantage plans are an all-in-one alternative to Original Medicare. They bundle your Part A (hospital insurance) and Part B (medical insurance) benefits into a single plan. This means one card to carry and often one company to deal with for all your hospital and doctor visits. Instead of getting your benefits directly from the federal government, a private insurer manages your care. This structure is the foundation for all the other differences you’ll see, from costs and provider choices to the extra benefits that many plans include.

A Look at Extra Benefits

One of the biggest draws of Medicare Advantage plans is the inclusion of extra benefits that Original Medicare doesn’t cover. Many plans offer routine dental, vision, and hearing coverage, which can be a huge help with expenses for cleanings, glasses, and hearing aids. You might also find benefits like gym memberships or fitness programs designed for seniors. These extras are meant to support your overall health and well-being. You can directly compare your coverage options on the official Medicare website to see a full breakdown of what’s included.

Understanding Provider Networks

Unlike Original Medicare, which lets you see almost any doctor or visit any hospital in the U.S. that accepts Medicare, Medicare Advantage plans typically use provider networks. These are often set up as HMOs or PPOs. This means you’ll generally need to use doctors, specialists, and hospitals that are part of the plan’s network to get the lowest costs. In some cases, you may also need a referral from your primary care physician to see a specialist. It’s essential to check if your preferred doctors are in a plan’s network before you enroll.

How Prescriptions Are Covered

Another key difference is how you get your prescription drug coverage. Most Medicare Advantage plans include prescription drug coverage (Part D) right in the plan. This is often referred to as a Medicare Advantage Prescription Drug plan, or MAPD. This bundling can be very convenient, as you won’t need to sign up for and pay a separate premium for a standalone Part D plan. For many, having medical and drug coverage combined under one plan simplifies managing their healthcare and monthly bills, making it part of The Big Choice between plans.

What is Coordinated Care?

Medicare Advantage plans often focus on a coordinated care approach. This means your primary care doctor, specialists, and hospital all work together to manage your health. Your primary doctor acts as the central point of contact, helping to ensure you get the right care at the right time and that all your providers are on the same page. This model can be especially helpful if you have chronic conditions, as it aims to provide more comprehensive and proactive healthcare. The goal is to keep you healthy and prevent small issues from becoming bigger problems.

Compare the Costs: A Side-by-Side Look

Let’s talk about money. When you’re choosing your Medicare coverage, understanding the costs is a huge piece of the puzzle. The way you pay for your care can look very different depending on whether you have Original Medicare or a Medicare Advantage plan. It’s not just about the monthly bill; it’s also about what you pay when you actually see a doctor or fill a prescription. Breaking down these costs can help you see which path might be a better fit for your budget and your peace of mind. Here’s a side-by-side look at what you can expect to pay with each option.

Monthly Premiums and Deductibles

With Original Medicare, most people don’t pay a premium for Part A (hospital insurance), but you will pay a monthly premium for Part B (medical insurance). If you add a separate Part D plan for prescriptions, that will have its own monthly premium, too. With a Medicare Advantage plan, you still need to pay your monthly Part B premium to the government. However, many Medicare Advantage plans have an additional premium of $0. In fact, about three-quarters of people in these plans pay no extra monthly premium for the plan itself. Both types of coverage also have deductibles you’ll need to meet before your insurance starts paying its share.

Copayments and Coinsurance

This is where the day-to-day costs can really differ. With Original Medicare, after you’ve met your Part B deductible, you’re generally responsible for 20% of the cost for most doctor visits and outpatient services. This is called coinsurance, and there’s no yearly limit on how much that 20% could add up to. Medicare Advantage plans work differently. Instead of a 20% coinsurance, you’ll usually pay a fixed amount, called a copayment, for doctor visits and other services. For example, you might pay a $20 copay for a visit to your primary care doctor or $50 to see a specialist. This structure can make your healthcare costs much more predictable from month to month.

Your Annual Out-of-Pocket Limit

One of the most important financial differences is the out-of-pocket limit. Original Medicare does not have a yearly cap on what you might have to pay for your 20% coinsurance. This means a serious illness could lead to very high medical bills. To protect against this, many people with Original Medicare buy a separate Medigap policy. On the other hand, all Medicare Advantage plans are required to have a yearly out-of-pocket maximum. Once you’ve spent that amount on copayments and deductibles for medical services, the plan pays 100% of your covered costs for the rest of the year. This provides a crucial financial safety net that Original Medicare alone doesn’t offer.

Thinking About Future Costs

When you’re healthy, it can be tempting to choose the plan with the lowest monthly premium. But it’s wise to think about what could happen if your health changes. If you expect to need a lot of medical care, the 20% coinsurance with Original Medicare could become very expensive over time. In that situation, a Medicare Advantage plan with a firm out-of-pocket maximum might save you a significant amount of money in the long run. It’s about balancing your monthly costs with protection against potentially high expenses in the future. Thinking about your long-term health needs can help you make a more informed decision today.

Staying Healthy with Preventive Care

Original Medicare does a great job of covering services and supplies that are considered medically necessary. However, it generally doesn’t cover routine care like most dental exams, vision checks for glasses, or hearing aids. These are expenses you would have to pay for entirely on your own. This is an area where Medicare Advantage plans often stand out. Most plans include extra benefits for routine dental, vision, and hearing care as part of their package. Having these services included in your plan can help you stay on top of your health and save money on the preventive care that keeps you feeling your best.

Exploring the “Extras”: Vision, Dental, and More

One of the most significant differences between Original Medicare and Medicare Advantage is the inclusion of extra benefits. While Original Medicare is a solid foundation covering your core hospital and medical needs, it leaves out several routine services that are important for your overall health. Many Medicare Advantage plans are designed to fill these gaps, bundling additional coverage into a single plan. These “extras” can include everything from dental check-ups to gym memberships, and they are often a key factor for people deciding which path to take. Let’s look at some of the most common extra benefits you might find.

Vision and Dental Coverage

As we get older, taking care of our teeth and eyes becomes more important than ever. Unfortunately, Original Medicare doesn’t typically cover routine dental care like cleanings, fillings, or dentures. The same goes for routine eye exams for glasses or contacts. These costs can add up quickly. This is where many Medicare Advantage plans step in. Most plans include benefits for routine dental and vision care, helping you pay for the check-ups and eyewear you need to stay healthy. It’s a practical benefit that can save you significant money out-of-pocket each year and help you maintain your health from head to toe.

Hearing Aids and Services

Hearing loss is common, but getting help can be expensive. Original Medicare generally doesn’t cover hearing aids or the exams for fitting them, leaving you to pay the full cost, which can be thousands of dollars. To address this, many Medicare Advantage plans offer hearing benefits. This coverage often includes routine hearing tests and may provide an allowance toward the cost of hearing aids. Having this support can make a world of difference, helping you stay connected to conversations with family and friends. When you review your plan options, be sure to check the specifics of the hearing coverage to see how it can help with these essential costs.

Wellness and Fitness Programs

Staying active is one of the best things you can do for your physical and mental health. Many Medicare Advantage plans encourage a healthy lifestyle by including fitness benefits at no extra cost. You’ve likely heard of programs like SilverSneakers, which give you access to a nationwide network of gyms and fitness classes, both in-person and online. These fitness programs are more than just a gym membership; they offer a great way to stay social, meet new people, and find activities you genuinely enjoy. From yoga and tai chi to strength training, these wellness benefits are designed to help you feel your best.

Help with Transportation and Post-Hospital Care

Sometimes, the biggest hurdles to getting good care have nothing to do with the doctor’s office. If you don’t drive or have limited mobility, simply getting to an appointment can be a challenge. Some Medicare Advantage plans address this by offering transportation services for non-emergency medical visits. Beyond just a ride, some plans also provide support after a hospital stay, such as delivering meals to your home while you recover. These thoughtful benefits can provide peace of mind, ensuring you can access the care you need and recover comfortably without added stress.

Bundling Your Drug Plan

With Original Medicare, you need to enroll in a separate, standalone Medicare Part D plan if you want coverage for your medications. This means another card to carry, another premium to pay, and another plan to manage. Most Medicare Advantage plans simplify this by including prescription drug coverage directly in the plan. These are known as Medicare Advantage Prescription Drug (MAPD) plans. This bundled approach means your medical, hospital, and prescription drug coverage are all handled by one company. It’s a convenient, all-in-one solution that makes managing your healthcare much more straightforward.

How to Access Your Healthcare

Beyond the costs and coverage details, one of the most significant differences between Original Medicare and Medicare Advantage is how you actually get your medical care. This is about your day-to-day experience: how you choose your doctors, whether you can see a specialist on your own, and what happens if you need care while traveling.

Think of it as the difference between having a map with every road open to you versus a guided tour with a set itinerary. Original Medicare gives you the map, offering broad freedom to see almost any doctor, anywhere in the country. Medicare Advantage plans provide the guided tour, with a structured network of doctors and hospitals designed to work together on your care. Neither approach is inherently better—the right one for you depends entirely on your health needs, your lifestyle, and how you prefer to manage your healthcare. Let’s walk through what this looks like in practice.

Choosing Your Own Doctor vs. Using a Network

Your relationship with your doctors is personal, and your Medicare choice plays a big role here. With Original Medicare, you have the freedom to visit any doctor or hospital in the U.S. that accepts Medicare. There are no networks to worry about, giving you a massive amount of flexibility, especially if you travel within the country or want to see a specific specialist who might not be in a local plan’s network.

Medicare Advantage plans work differently. They use a network of specific doctors, hospitals, and providers. To keep your costs low, you generally need to use providers within that network. This is a key way these plans manage costs and coordinate care. Before enrolling, it’s essential to check if your favorite doctors and preferred hospitals are included in the plan’s network.

Will You Need Referrals to See Specialists?

If you need to see a specialist like a dermatologist or cardiologist, the process can vary. Under Original Medicare, you typically don’t need anyone’s permission to make an appointment; you can just call and schedule it yourself. This direct access is a major benefit for people who want more control over their healthcare decisions.

In contrast, many Medicare Advantage plans, particularly HMOs, require you to get a referral from your primary care physician (PCP) before you can see a specialist. This means you’ll need an appointment with your PCP first to get their approval. While it’s an extra step, the goal is to ensure your care is coordinated, with your main doctor always in the loop about your health.

How Emergency Care Works

When you have a medical emergency, you should always seek care immediately. The good news is that both Original Medicare and Medicare Advantage plans cover emergency care anywhere in the United States. Where they differ most is with care outside the country.

Original Medicare generally does not cover you when you’re traveling abroad. If you’re a world traveler, you might want to purchase a Medigap policy, as some of these plans cover emergency care abroad. Medicare Advantage plans also typically limit coverage to the U.S., but some plans offer supplemental benefits for emergency or urgent care when you’re traveling internationally. It’s important to check the specific details of any plan you’re considering.

What Happens if You Go Out-of-Network?

This is a critical point to understand, as it can have a big impact on your wallet. With a Medicare Advantage plan, seeing a provider outside the approved network can lead to much higher out-of-pocket costs, or the plan may not cover the service at all. Some plan types, like PPOs, offer more flexibility for out-of-network care but at a higher cost than staying in-network.

With Original Medicare, you don’t have to worry about networks. As long as your doctor or hospital accepts Medicare, you’re covered. This straightforward approach eliminates the risk of surprise bills for accidentally going “out-of-network” and gives you peace of mind knowing your coverage is consistent across the country.

The Benefits of a Coordinated Care Team

While networks and referrals can feel restrictive, there is an upside to the Medicare Advantage model: coordinated care. With these plans, your primary care physician often acts as the leader of your healthcare team. They are kept aware of the care you receive from specialists, which helps ensure everyone is on the same page. This can be especially valuable if you are managing chronic conditions.

This coordinated approach is designed to provide more holistic oversight of your health. It’s also part of the structure that allows Medicare Advantage plans to offer extra benefits not covered by Original Medicare, such as routine dental, vision, and hearing services. By managing care within a network, these plans can often provide more comprehensive coverage in one package.

How to Choose the Right Path for You

Deciding between Original Medicare and a Medicare Advantage plan feels like a huge choice because it is. But it doesn’t have to be overwhelming. The best path forward depends entirely on your personal situation—your health, your budget, and your lifestyle. By thinking through a few key areas, you can find the coverage that truly fits your life. Let’s walk through the most important factors to consider.

Assess Your Health Needs

Start by taking stock of your current health and what you might need in the future. Do you take regular medications? Do you need glasses or dental work? If you need prescription drugs, dental, vision, or hearing coverage, a Medicare Advantage plan often includes these benefits bundled together. Original Medicare, on the other hand, doesn’t cover these things, so you would need to buy separate standalone plans. Thinking about your health needs first helps you narrow down which type of coverage makes the most sense from the start.

Review Your Budget

Your financial picture is another critical piece of the puzzle. While Original Medicare has lower premiums for most people, it doesn’t have a yearly limit on what you might pay out of pocket. In contrast, every Medicare Advantage plan has a yearly limit on how much you pay for medical services, which can offer peace of mind and financial predictability. Consider what you can comfortably afford for monthly premiums versus what you could handle in out-of-pocket costs if you had a major health event. This balance is different for everyone.

Check if Your Doctors Are Covered

Do you have doctors you love and want to keep seeing? This is a non-negotiable for many people. With Original Medicare, you can see any doctor or hospital in the U.S. that accepts Medicare. This gives you incredible freedom and flexibility. Medicare Advantage plans, however, usually have a network of doctors and hospitals you must use to get the lowest costs. Before you even consider a specific Advantage plan, you should always compare your coverage options and confirm that your trusted providers are in its network.

Consider Your Travel Plans

If you’re a snowbird or just love to travel, your Medicare choice can have a big impact. Original Medicare offers more flexibility if you travel a lot within the United States because it’s a national program. You’re covered anywhere in the country as long as the provider accepts Medicare. Most Medicare Advantage plans have local or regional networks, which means your coverage might be limited to emergency or urgent care when you’re away from home. If you spend a significant amount of time in different states, this is a major factor to weigh as you choose your plan.

Plan for Any Chronic Conditions

If you’re managing an ongoing health issue, you want to ensure your coverage supports your needs without creating barriers. For those with chronic conditions, the freedom to see specialists is often a top priority. If you want the option to see top specialists without worrying about network limits or getting referrals, Original Medicare might be a better choice. This flexibility can be crucial for getting the specific care you need. With a Medicare Advantage plan, you’ll want to be sure any specialists you need to see are in the plan’s network.

Key Enrollment Periods and Rules

Timing is everything when it comes to Medicare. You can’t just sign up or change your plan whenever you feel like it; you have to follow a set schedule. Missing a deadline can lead to gaps in coverage or even lifelong penalties, so it’s important to know these dates. Think of them as your key opportunities to make sure your health plan is the right fit for you. Let’s walk through the most important enrollment periods and the rules that go with them.

Your First Chance to Enroll

Your first opportunity to sign up for Medicare is called your Initial Enrollment Period. This is a seven-month window that’s unique to you. It starts three months before the month you turn 65, includes your birthday month, and ends three months after your birthday month. For example, if your birthday is in May, your enrollment period runs from February through August. This is your prime time to enroll in Part A and Part B, and to decide if you want to add a Medicare Advantage or Part D plan. It’s best to sign up for Medicare early in this window to ensure your coverage starts on your 65th birthday.

The Annual Open Enrollment Period

Every year, you get a chance to review your coverage and make changes during the Annual Enrollment Period (AEP). This period runs from October 15 to December 7. During this time, you can switch from Original Medicare to a Medicare Advantage plan, or go from a Medicare Advantage plan back to Original Medicare. You can also switch from one Medicare Advantage plan to another, or change your Part D prescription drug plan. This is the perfect time to reassess your health needs and budget to confirm your current plan is still working for you. Any changes you make will take effect on January 1 of the following year.

Qualifying for a Special Enrollment Period

Life happens, and sometimes you need to change your health plan outside of the usual enrollment times. That’s where a Special Enrollment Period (SEP) comes in. You may qualify for an SEP if you experience certain life events, like moving to a new address that isn’t in your current plan’s service area, losing your employer health coverage, or becoming eligible for both Medicare and Medicaid. There are many different situations that can trigger an SEP, so it’s worth checking the official list of Special Enrollment Periods to see if your circumstances qualify you to make a change.

The Rules for Switching Plans

If you’re already enrolled in a Medicare plan and want to make a change, you need to do it during a valid enrollment period. For most people, that means waiting for the Annual Enrollment Period from October 15 to December 7. This is your yearly window to switch plans if you’re unhappy with your current coverage or find a better option. If you have a Medicare Advantage plan, there’s also an Open Enrollment Period from January 1 to March 31 when you can switch to another Advantage plan or go back to Original Medicare. Otherwise, you’ll need to qualify for a Special Enrollment Period to make a mid-year adjustment.

Getting Help from an Expert

Feeling overwhelmed by all these rules and dates? You’re not alone. The good news is that you don’t have to figure it all out by yourself. There are free, unbiased resources available to help you. Your State Health Insurance Assistance Program (SHIP) offers personalized counseling. You can also contact Medicare directly with your questions. For many people, talking with a licensed insurance agent who specializes in Medicare provides the clarity they need. An expert can help you compare your options and find a plan that truly fits your life. You can always get help from these trusted resources to make a confident decision.

Let’s Clear Up Some Common Myths

Medicare can feel like a puzzle with a lot of moving parts, and it’s easy to get tripped up by misinformation. When you hear different things from friends, family, or commercials, it’s tough to know what’s true. Let’s walk through some of the most common myths about Original Medicare and Medicare Advantage to give you a clearer picture. Getting the facts straight is the first step to choosing the coverage that truly fits your life.

Myths About Costs and Coverage

One of the biggest misconceptions is about out-of-pocket costs. Many people assume Original Medicare has a safety net for spending, but it actually does not have a yearly limit on what you might pay for medical services. This is where a Medigap plan can be a huge help. On the other hand, a common myth about Medicare Advantage is that the costs are unpredictable. In reality, all Medicare Advantage plans are required to have an annual out-of-pocket maximum. Once you reach that limit, the plan pays 100% for your covered services for the rest of the year, which can provide significant financial protection.

Myths About Doctor Networks

Another area of confusion is doctor access. Some believe Original Medicare limits your choice of providers, but the opposite is true. With Original Medicare, you have the freedom to see any doctor or visit any hospital in the U.S. that accepts Medicare, and you typically don’t need a referral to see a specialist. Conversely, many think Medicare Advantage plans offer the same flexibility. Most MA plans, however, operate with a network of doctors and hospitals. Seeing a provider outside that network could mean you’re responsible for a much larger portion of the bill, or even the entire cost.

Myths About When You Can Enroll

Timing is everything with Medicare, and there are myths that can cause big problems. A common one is that you’re locked into your first choice forever. The good news is that you can switch plans during the Annual Open Enrollment Period, which runs from October 15 to December 7 each year. A more dangerous myth is that delaying your enrollment isn’t a big deal. If you miss your Initial Enrollment Period when you first become eligible, you could face late enrollment penalties for the rest of your life and may have to wait for a specific time to sign up, leaving you with a gap in coverage.

Myths About Supplemental Insurance

Finally, let’s talk about extra insurance. Some people think you can’t add more coverage to Original Medicare. In fact, you can purchase a separate Medigap policy to help pay for things like deductibles and copayments. This is a key feature that helps many people budget for their healthcare costs. The flip side of this myth is the belief that you can pair a Medigap plan with a Medicare Advantage plan for maximum coverage. This is not true—it is illegal for anyone to sell you a Medigap policy if you are enrolled in a Medicare Advantage plan. You must choose one path or the other.

Frequently Asked Questions

If I choose a Medicare Advantage plan, can I still see my current doctors? This is one of the most important questions to ask. With a Medicare Advantage plan, you generally need to use doctors and hospitals that are in the plan’s network to keep your costs down. Before you enroll in any plan, you should confirm that your trusted doctors, specialists, and preferred hospitals are included. If you choose Original Medicare, you have the freedom to see any doctor in the country that accepts Medicare, so you don’t have to worry about networks.

Which option is better if I have a serious or unexpected health problem? This really comes down to how your financial protection is structured. All Medicare Advantage plans include a yearly out-of-pocket maximum, which acts as a financial safety net. Once you spend that amount, the plan covers 100% of your approved medical costs for the rest of the year. Original Medicare does not have a yearly limit on your costs, which means your 20% coinsurance could add up significantly. That’s why many people with Original Medicare also buy a Medigap policy to cover those gaps and create their own safety net.

Do I need to buy a separate prescription drug plan with both options? No, this is a key difference between the two paths. If you choose Original Medicare and want coverage for your medications, you will need to sign up for a separate, standalone Part D prescription drug plan. Most Medicare Advantage plans, however, bundle this coverage right into the plan. This all-in-one approach is a major reason people find Medicare Advantage convenient.

Why would I choose Original Medicare if Advantage plans offer extra benefits like dental and vision? It’s true that the extra benefits in many Medicare Advantage plans are a big draw. The choice often comes down to a trade-off between benefits and freedom. In exchange for those bundled dental, vision, and hearing benefits, you agree to use the plan’s network of doctors and, in some cases, get referrals to see specialists. With Original Medicare, you trade those built-in extras for the flexibility to see almost any doctor or specialist in the country without needing a referral.

Can I switch from a Medicare Advantage plan back to Original Medicare if I don’t like it? Yes, you can make a change, but your timing is important. You aren’t locked in forever. Every year, you have the opportunity to switch plans during the Annual Enrollment Period, which runs from October 15 to December 7. During this window, you can move from a Medicare Advantage plan back to Original Medicare. Just keep in mind that if you switch back, you may need to go through medical underwriting to get a Medigap policy, which isn’t always guaranteed.