It’s great to have healthcare options. It’s better when you’re confident about which plan will work best for you now and in the future. But, since the original version of Medicare and Medicare Advantage are so similar, it’s a difficult decision.
The slight differences can have a significant impact on your care. So, when given a choice between the original version of Medicare and Medicare Advantage, how do you choose? Which one aligns with your healthcare and financial needs?
Considering both elements, we suggest the Original Medicare plan.
And, here’s why.
What is Original Medicare?
The federal government provides Original Medicare plans.
These plans include Parts A and B:
- Part A: This is your hospital insurance, covering hospital stays, hospice, home health, and nursing facilities. If you meet the government’s work requirements, Part A will be free.
- Part B: This is your medical insurance, covering medically necessary outpatient services—think lab testing, chemotherapy, ambulance rides, and surgeries. While Part A covers the basics, you’ll still need Part B to cover the additional services that you’ll receive in the hospital, nursing facilities, etc.
What is Medicare Advantage?
Here’s where most people are lost. Medicare Advantage is Medicare Part C. Simply put, this is a privatized version of Medicare. Note that Part C is not just another part of Original Medicare; it’s separate, private insurance.
Medicare Advantage provides Part A, B, and (sometimes) D from one carrier. Part D being prescription insurance, which you can choose to opt into for an extra premium on your Original Medicare plan if you’d like additional coverage.
Why Choose Original Medicare over Medicare Advantage?
We advise most of our clients to choose Original Medicare instead of Medicare Advantage (Part C)., but this is dependent on each individual’s circumstances. In addition to it being more versatile and cost-effective, here are three reasons we suggest it.
1. No Surprises
Original Medicare is unique in that you know exactly how much you’ll pay. Even with larger events like a chronic illness or a hospital stay, you always pay the same amount. This security gives you peace of mind that you can prepare financially for possible health issues down the road.
Protecting your from surprise (read scary) medical bills, Original Medicare sets a limit for how much you can be charged by both participating and non-participating providers.
2. More Flexibility
You’ll have access to Medicare’s network throughout the entire country. Because you don’t choose a primary care provider, you also aren’t required to have a referral to see a specialist. While beneficial for anyone, this is especially great for those who travel frequently or who want more control over the providers they see.
Additionally, privatized insurance plans could choose to reject your application if they feel that it’s too much of a risk. Original Medicare will accept you regardless of your pre-existing conditions.
3. Gap Coverage Options
Unlike Medicare Advantage, Original Medicare allows you to add supplemental insurance, called Medigap, for an additional premium. This would cover some of the additional costs that are not covered under the Original Medicare plan.
While Medicare Advantage will usually have a lower premium than Medigap, it’s not cost-effective for the long term because you’ll pay more in co-pays over time.
Have More Questions?
While Medicare.gov is a great resource to answer a few of your more basic questions, a financial advisor digs in deep. We do the more challenging research, so that we can explain Medicare and Medicare Advantage in plain terms, without the confusing lingo.
Our goal is to create a comfortable, welcoming environment where you feel free to ask questions about your healthcare insurance so that we can talk through your options one on one. For those in the Nashville and Franklin area, you might consider us your local Medicare professional.
We Can Help
The Nail Wealth Team is helping your neighbors right here in Franklin. Reach out to our local office to set up a consultation appointment. We can talk you through how we help our clients meet their dream financial goals. And, you’re sure to feel like part of our family.
For a hometown touch, contact us today to learn more.
