CHOOSING BETWEEN ORIGINAL MEDICARE AND MEDICARE ADVANTAGE
Now that you understand the basics of each type of plan, you’ll also want to consider other factors when making your choice:
Which doctor(s) you want to go to
With Original Medicare, you can visit any doctor in the United States that accepts Medicare. With Medicare Advantage, however, you are limited to the providers in your specific network. Most insurance plans have a website where you can check if your doctors are in-network. You can also call the insurance company or your doctor.
When deciding what options best fit your budget, ask yourself how much you spent on health care last year. Keep this number in mind while reviewing your different plan options. For example, Original Medicare plans do not have an out-of-pocket maximum, but Medicare Advantage plans do. If you need a lot of health care services, A Medicare Advantage plan might help you reduce your overall costs by setting a limit on how much you will pay out of your own pocket in a single year.
How often you travel
Because Medicare Advantage plans have a network of providers within a certain geographical area, you may be limited in your health care options. If you travel frequently or stay in another place long-term (like visiting your grandkids for the summer) and need ongoing care, make sure you can find a provider in-network. Or, make sure you have room in your budget to pay for out-of-network health care services. Many Medicare Advantage plans will cover emergency services while traveling, but not routine care.
Your long-term health care needs
If you are generally healthy and don’t need a lot of medical care, Original Medicare might be enough. But, if you have prescription drugs or want coverage for other types of care (like vision or dental), a Medicare Advantage plan might be best. The good news is that once you pick a plan, you are not stuck with it. If your situation changes, you can change your plan to better fit your needs designated open enrollment periods.