Original Medicare vs Medicare Advantage: What's the Best Option?

When you enroll in Medicare for the first time, you can choose how you get your coverage. The two main ways are through Original Medicare or Medicare Advantage. The plan you choose will affect how much coverage you get, the doctors you can see and the quality of care you receive. This is why it’s such an important decision! 

The good news is that you can make changes to your plan during fall open enrollment if you’re unhappy with your coverage. To help you navigate through Medicare quotes in NJ, let’s break down the two different coverage options and what to expect from each one.

Original Medicare vs Medicare Advantage: What’s the Best Option? 

Original Medicare:

- Original Medicare includes Medicare Part A (hospital insurance) and Part B (medical insurance). If you want prescription drug coverage, you can add a Part D plan. 

- You can choose any doctor or hospital that accepts Medicare. 
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- To help with your out-of-pocket costs, you can purchase Medigap supplement insurance.

Medicare Advantage: 

- Medicare Advantage (also known as Part C) is an all-in-one alternative to Original Medicare, combining Part A, Part B and Part D.

- Advantage plans typically have lower out-of-pocket costs. 

- You can only use doctor’s who are in your plan’s network.

- Most plans offer extra benefits that are not included with Original Medicare like vision, hearing and dental. 

Is One Better than the Other? 

There is no one-size-fits-all solution when it comes to Medicare. The best approach is to meet with a financial advisor in New Jersey who is knowledgeable in Medicare and Medigap plans. They can go over your options and help you determine the best fit for your needs, health status and budget. That said, here are some key points to consider.

- Doctor and hospital choice. Original Medicare allows you to go to any hospital or doctor that accepts Medicare. Medicare Advantage requires you to use doctors in your plan’s network and may ask for referrals to see a specialist.

- Cost. Out-of-pocket costs are usually lower with Medicare Advantage but you have a yearly limit on what you pay. You also can’t buy or use separate supplemental coverage. Original Medicare usually requires you to pay 20% after you meet your deductible. There’s no yearly limit and supplemental plans are allowed.

-Coverage. Original Medicare covers most medical necessities and supplies. You can also join Part D for prescription medications. Medicare Advantage includes prescription drug coverage, as well as extra benefits like vision, hearing and dental. 
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- Travel. If you travel outside the U.S., Original Medicare probably won’t cover your care. However, Medigap plans may. Medicare Advantage plans also won’t cover international healthcare expenses. 

Looking to apply for Medicare in New Jersey? Contact Leonard Financial Solutions for a detailed look at your individual healthcare needs. Many clients find that they can get the best and most comprehensive healthcare coverage by combining Original Medicare with a supplemental plan. Let’s chat and find the best options for you!