Original Medicare
vs.
Medicare Advantage

Original Medicare differs from Medicare Advantage plans in several aspects ranging from cost, out-of-pocket maximum, providers network, drug coverage, additional benefits and more. The table below summarizes the major differences between Original Medicare Medicare Advantage plans.




Original Medicarevs.Medicare Advantage
You Pay Medicare Part B Premium. You may have to pay Part A Premium if you don't meet certain criteria. You are generally required to pay deductibles and coinsurance of both Parts A and B.CostYou continue to Pay Medicare Part B Premium, Part A Premium any, and the monthly Premium of the Medicare Advantage, if any. Whenever you access healthcare services, you are generally required to pay copayments, coinsurance and/or deductibles.
Original Medicare has No Network. Your may visit any medical facility and provider across the United States that accept Medicare.NetworkMedicare Advantage plans have Network of provider that you have to stay within. However, emergency and urgent care visits are always covered when traveling in the United States.
You may choose any doctor and hospital that are contracted with Medicare and accepting Medicare patients.Doctors & HospitalsYou may be required to choose from the plan network of
physicians and hospitals.
You may use any specialist without a referral from your Primary Care PhysicianSpecialist ReferralsReferrals may be required
before seeing specialists.
Original Medicare does not cover prescription drugsPrescription Drug
Coverage 		Most Medicare Advantage Plans include prescription drugs embedded with the plan. 
Most people enroll in Original Medicare when the turn 65. You can apply for Original Medicare 3 months before the month of the 65th birthday and 3 months after the month you turn 65.Enrollment PeriodsThere are specific periods (IEP, MA OEP, Medicare AEP) during the year to enroll or switch plans. Medicare Advantage has no underwriting.
Medicare Parts and B have no Out-Of-Pocket-Maximum. Medicare Part A has a deductible of $1,600 (for 2023) payable in each benefit period. Medicare Part B has a deductible of $226 (for 2023) and 20% coinsurance. Out-of-Pocket
Maximums		CMS requires all Medicare Advantage plans to have a Maximum-Out-Of-Pocket.
Original Medicare does not cover vision, dental and hearing servicesVision, Dental, and
Hearing Services		Most Medicare Advantage plans offer Eye exams, eyeglasses and corrective lenses; Dental exams, cleanings and X-rays; Hearing tests and hearing aids
Original Medicare does not provide coverage for travelling abroad.Foreign TravelMost Medicare Advantage plans do not provide additional coverage for traveling abroad with the exception of medical emergencies.
You can enroll in Original Medicare regardless if you have a Pre-Existing condition. Pre-existing conditionsYou can enroll in Medicare Advantage plans regardless if you have a Pre-Existing condition. 
Original Medicare does not provide additional benefitsAdditional BenefitsSome Medicare Advantage plans offer additional benefits like fitness and wellness programs, transportation services, home modification/
maintenance services, telehealth and social worker teleservices, and more. 

Vision Insurance Group, LLC.

Clients

Services

Sign up for our Newsletter

© Copyright 2025 Vision Insurance Group, LLC - All Rights Reserved

Privacy Statement | Terms of Use | Disclaimers