How to choose between Medicare vs. Medicare Advantage

Young woman explaining the difference between Medicare Advantage vs Original Medicare to a Medicare eligible couple

Should you go with Original Medicare, which includes Medicare Parts A and B? Or should you apply for a Medicare Advantage plan, also known as Medicare Part C? Your personal budget and your coverage needs are all factors. It's important to know the difference between Original Medicare and Medicare Advantage when you compare plans to see what works best for you.

Medicare Advantage vs. traditional Medicare

Traditional Medicare (also called Original Medicare) includes Medicare Part A and Part B, which gives you inpatient and outpatient coverage. Medicare Advantage plans (Part C) include Part A and Part B coverage plus much more.

Medicare Part A covers:

Hospital stays (semi-private rooms) up to 60 days
Hospital meals
Nursing services
Intensive care services
Drugs, medical supplies and equipment used on the premises
Lab tests and X-rays taken while hospitalized
Surgery and recovery costs
Rehabilitation and therapy services
Part-time home nursing care

Medicare Part B covers:

Doctor visits
Vaccinations and flu shots
Health screenings and medical tests
Medical supplies
Ambulance services
Smoking cessation and other preventive health care programs

Medicare Part C (Medicare Advantage) includes:

Everything Medicare Part A and Part B covers
Additional coverage for things like dental, hearing, vision, prescription drugs, and more

Do Medicare Advantage plans replace Original Medicare?

Medicare Advantage plans can replace Original Medicare plus provide additional coverage depending on the plan you choose.

When looking at the differences between Medicare and Medicare Advantage, keep in mind that Medicare Advantage plans are offered through private insurers like Empire. They include everything that Part A and Part B cover, plus lots of other benefits that Original Medicare doesn’t cover. Think of a Medicare Advantage plan as comprehensive coverage for your healthcare needs.

Some of the benefits most Medicare Advantage plans have that Original Medicare does not have include:

Prescription drug coverage

Medicare Advantage prescription drug (MAPD) plans are Part C plans combined with Part D prescription drug plans. While Medicare Part D provides only prescription drug coverage, Medicare Advantage plans can be combined to cover that and more.

Dental care

Many Medicare Advantage plans offer dental coverage for things like routine checkups and exams, cleanings, dentures, and coverage for unplanned dental procedures like root canals and crowns.

Vision care

Eye health becomes more important as we age. Eye exams, glasses, and contacts are a part of many Medicare Advantage plans.

Hearing care

Original Medicare doesn't cover hearing aids, which can be expensive. Many Medicare Advantage plans provide hearing coverage that includes testing and medically required hearing aids.

Wellness and fitness

Medicare Advantage plans give you options for maintaining a healthy lifestyle. Many plans include access to gym memberships, senior fitness programs like SilverSneakers®, and coaching to improve overall well-being.

Compare the costs: Medicare vs. Medicare Advantage

Original Medicare

If you or your spouse worked and paid Medicare taxes, you will most likely receive Part A premium-free with Original Medicare. Part B with Original Medicare has a premium and a deductible. Both of your Part B costs are based on your lifetime earnings, so low-income beneficiaries may pay less for Part B.

Medicare Advantage

The cost of Medicare Advantage plans varies depending on where you live. Some plans have $0 premiums. On average, your monthly premiums are usually lower than what you pay for Medicare Part B with Original Medicare.

Why enroll in a Medicare Advantage plan?

As you become older, healthcare protection becomes more important than ever. More coverage can offer more peace of mind, so you don't get surprise medical bills in the event of a sudden injury or illness.

Medicare Advantage plans can also offer more value. With the right plan, you can save on costs for dental, vision, prescription drug coverage, and more.

Because private insurers like Empire offer Medicare Advantage plans, you also have more flexibility with your plan selection. You can tailor your coverage to fit your healthcare needs.