Unlike Original Medicare, which is administered by the federal government, Medicare Advantage (also known as Medicare Part C) is sold by private insurance companies. Some other differences between Medicare Advantage and Original Medicare are listed below.
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One key differentiating benefit of enrolling in a Medicare Advantage plan is the annual cap on out-of-pocket spending. Under a Medicare Advantage plan, you’ll have a limit to how much you have to pay for Medicare services each year. The out-of-pocket spending limit amount can vary based on your plan.
In the case that you have health problems and need medical care often, or require expensive care, an out-of-pocket limit can be helpful. After you reach the annual out-of-pocket limit, your plan pays the full cost of your care. Part A and Part B do not offer an out-of-pocket maximum benefit.
In terms of additional coverage offered by Medicare Advantage plans, routine vision and dental services are among the most common. Some plans also offer hearing benefits, and/or memberships to health and wellness programs.
In 2020, some Medicare Advantage plans began to offer new benefits to beneficiaries with chronic illnesses, according to Medicare expert John Barkett. To learn more about these benefits, watch the video below.
Additional benefits can vary across plans.
Many Medicare Advantage plans include prescription drug coverage in their benefit packages. Called a Medicare Advantage Prescription Drug Plan (MA-PD), this type of policy allows beneficiaries to get their hospital, medical, and drug coverage all under one plan — and in some cases, the additional benefits mentioned above.
Each Medicare Advantage plan features its own unique benefits package. For help finding the plan that best fits your personal health care needs, call to speak with a licensed insurance agent today.
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Christian Worstell is a licensed insurance agent and a Senior Staff Writer for MedicareAdvantage.com. He is passionate about helping people navigate the complexities of Medicare and understand their coverage options.
His work has been featured in outlets such as Vox, MSN, and The Washington Post, and he is a frequent contributor to health care and finance blogs.
Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism. He currently lives in Raleigh, NC.
Where you've seen coverage of Christian's research and reports:
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