Medicare or Medicare Advantage:
Which One is Best for You?

You’ve been working for most of your life and the time has come to finally retire. Looking forward to traveling, fishing, volunteering at your favorite organization or church, and enjoying your days with your loved ones. You’ve paid into FICA all your working years and now it’s time for it to pay back with Social Security and Medicare. However, there are options with Medicare you may not be familiar with: Original Medicare or Medicare Advantage, which one is best for you? Let’s take a look.

To understand and learn which option is best for you, you need to understand the differences and similarities between the two options.

Original Medicare

Medicare (also known as Original Medicare) is administered by the federal government. It comes in two parts: Part A and Part B.

Medicare Part A is your hospitalization insurance. If you need emergency care or to be hospitalized, this is the part which pays for those services.

Part B is your general medical insurance. It covers doctor visits, lab tests, home health care, durable medical equipment and certain preventive services. This is collectively known as outpatient services.

With Original Medicare, you can see any doctor that accepts Medicare. However, keep in mind that you will pay 20% of all doctor and hospital costs. In addition, there’s a copay of $1,450 for the first 24-hours of inpatient care. Also, keep in mind that Medicare Supplements only pay what is Medicare approved care. Medicare will ONLY pay for what is medically necessary.

Part A is provided with no premium (a premium is your monthly fee). However, Part B has a monthly premium. Important note: if you fail to subscribe on time for your Medicare benefits, you will pay a permanent late fee, which is determined by how late you are and how long you’ve been without Part D, the prescription portion of the Medicare. So, don’t miss what is known as your IEP, or Initial Enrollment Period.

Since I mentioned Part D, know that if you choose Original Medicare, you will need to purchase a Part D prescription drug plan. The cost for your Part D and the Part B premium are the monthly premiums you must pay.

Medicare Advantage

All Medicare Advantage plans offer what Original Medicare offers, but that’s where the similarities end. The first main difference between Original Medicare and Medicare Advantage is that Medicare Advantage is provided and administered by a private health insurance company which has been vetted and approved by Medicare. Medicare Advantage gives you options not available with Original Medicare, and includes Part A, Part B and Part D under one umbrella, (this is known as Medicare Part C). Part C makes it very convenient and lowers your monthly premium costs.

Depending on your Medicare Advantage plan, you may have no premium or a low premium, in addition to the Part B premium which is required by law and typically deducted from your social-security monthly deposit or check.

Additional Benefits of Medicare Advantage

Medicare Advantage covers all preventive care, and includes:

• Doctors and specialists, and whatever your doctor says you need (Part B)
• Prescription medication (Part D)
• Dental
• Vision
• Hearing
• Fitness club memberships
• And provides a limited amount of FREE OTC (over the counter) medical supplies like band-aids, aspirin, ace bandages, and more.

In short, the 20% Original Medicare does NOT cover is included in your Medicare Advantage Plan. This provides savings that help stretch your retirement dollar, convenience of not having to juggle multiple plans to piece to together your needs for medical care, and provides added savings like the fitness club membership which can cost anywhere from $10 to $50 a month, depending on your club. Moreover, the over the counter supplies means you’re not buying Neosporin, Band-aids, Tylenol and other items from your pocket.

So, get your questions answered by your Medicare Professional. If you’re in the following states:

• Florida
• Illinois
• Indiana
• Maryland
• Michigan
• New York
• North Carolina
• Virginia
• Or Wisconsin

Covenant Keepers Benefits can answer all your questions, find which plans are available in your area, and help you identify which plan offers the most benefits and savings.

So there you have it. Make sure you know what your IEP is and don’t miss it. If you are already a Medicare or Medicare Advantage recipient, then make sure to get a second opinion on what you’re currently using. Plans change annually. Be certain changes don’t affect the care you need. Get your questions answered early, know your options and be prepare for Open Enrollment in October. You’ll be glad you did.