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  • Writer's pictureJessica Wynn, MPH, RN

Defining Differences Between Medicare Advantage and Original Medicare?

Updated: Jun 25, 2023


Medicare Advantage is also known as "Part C" and Original Medicare is known as "Part A" and "Part B" which are both programs offered by the federal government to provide healthcare coverage to those who are eligible for Medicare.


Original Medicare is the traditional fee-for-service program that covers hospital and medical expenses. It includes Part A, which covers inpatient hospital care, hospice care, and skilled nursing facility care, and Part B, which covers doctor visits, diagnostic tests, and other medical services.


Medicare Advantage, on the other hand, is a program that allows beneficiaries to receive their Medicare benefits through private insurance plans, rather than the traditional fee-for-service program. These plans are offered by private insurance companies that are contracted with the federal government. Medicare Advantage plans typically include additional benefits beyond what Original Medicare covers, such as vision, hearing, and dental coverage, as well as prescription drug coverage.


Some key differences between Original Medicare and Medicare Advantage include:


  • Original Medicare is a federal program, while Medicare Advantage is offered by private insurance companies.

  • Original Medicare allows beneficiaries to seek care from any healthcare provider who accepts Medicare, while Medicare Advantage plans may have a network of providers that beneficiaries must use.

  • Original Medicare does not include prescription drug coverage, while many Medicare Advantage plans do.

  • Original Medicare beneficiaries may have to pay out-of-pocket costs such as deductibles, coinsurance, and copays, while Medicare Advantage plans may have different cost-sharing arrangements or cap out-of-pocket costs.


It's important to note that beneficiaries can only choose one coverage option and cannot have both Original Medicare and Medicare Advantage at the same time.


For a review of your options, plans, and pricing contact Jessica Wynn, MPH,RN at Seven Insurance Corp for a free assessment. www.seveninsurehealth.com


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