I often surprise people when I say this, but there’s not one, but TWO Medicare Programs. There’s “Original Medicare,” which is the public option and is run by the government. Then there’s “Part C” (which is also known as Medicare Advantage). This is the private open and is run by private insurance companies. If you are eligible for Medicare, you have a choice to receive your benefits either through Original Medicare OR Part C.
Which is the better deal for me?
Medicare is not a one-size-fits-all kind of program. You need to sit down and think through all of your health care needs, as well as what kind of health care services you will need in the future. Then you have to determine if Original Medicare or Part C (“Medicare Advantage” plans) are better for you.
Original Medicare is made up of two parts: Medicare Part A (the services available under Medicare Part A help you pay for medical bills that you get while you’re in the hospital) and Medicare Part B (the services available under Medicare Part B helps you pay for “outpatient services” like doctor’s visits). While all health providers do not accept Original Medicare, the vast majority do. This means that you will be able to go to almost any health provider of your choice to receive treatment.
Original Medicare does not usually pay for all of your medical bills, which will leave you with out-of-pocket costs. However, you can buy a Medigap policy to help you cover most, if not all, of your remaining expenses. You will also have to purchase a separate Part D plan for your prescription drug coverage.
Part C (Medicare Advantage plans) gives you most of the same benefits that Original Medicare gives you. These plans also often include Part D prescription drug benefits so that you don’t have to search for Part D plan yourself. However, with Part C (Medicare Advantage plans), there is a limited number of providers that you can go to when you get sick. This means that you do not have the same freedom to choose your doctors as you would in Original Medicare. Furthermore, generally speaking, your Part C plan has to approve of the care that you will receive before you can receive it. This can put you at odds with your health provider if you reasonably believe that you need certain treatment that your health provider is unwilling to pay for.
Different strokes work for different folks. Whether you choose Original Medicare or a Part C plan, make sure that it fits your health needs, current and future.