Medicare vs. Medicare Advantage: Which Is Better?

Medicare and Medicare Advantage are a whole world of different options. What are some of the differences between these two types of health insurance? What makes one a little better or worse than the other? 

I want to state right away, one’s not better or worse than the other. These are both very, very, very good coverage options. 

The Basic Difference Between Medicare and Medicare Advantage

If a person’s covered with Medicare, they would have a traditional health care insurance plan and a separate prescription drug plan which is called Medicare Part D. That is what we call traditional Medicare. That means your coverage is provided by the government. 

When a person joins a Medicare Advantage Plan, they opt out of government insurance. They choose a private health insurance company that offers a comparable plan. 

How to Make Your Choice Between Medicare and Medicare Advantage

What are the differences that enable a person to choose? There are four areas to look at, listed by priority, more or less:

  1. First, it’s a bit ideologic. Do you like having your health insurance provided by the government, or do you prefer getting insurance with a private insurance company? That’s one distinction.
  2. Secondly, what are the cost differences? That means you look at the affordability of the premiums. Our government charges everybody that participates with Medicare a premium for Medicare Part B. You’re going to pay that premium no matter what decision you make. The additional cost that I’m referring to would be the cost of the premium for a supplement to the basic Medicare plan, the separate prescription drug plan. When you have a Medicare Advantage plan with a private company, there is no additional premium for a prescription drug plan. Sometimes just the affordability of the premium for the prescription drug coverage could be an issue.
  3. The third area you want to look at is the extent of the prescription drug coverage. The prescription drug coverage in general under a Medicare Advantage plan has higher levels of prescription drug coverage than the separate prescription drug coverage plan under Medicare Part D. Under the Medicare Advantage plans, plans in Missouri and specifically St. Louis, are currently zero deductible plans. When you have Medicare Part D, those typically have a $500 or $540 deductible. So just right out of the gate, that could be a difference for some people.
  4. Fourth, you absolutely want to check and confirm your doctor’s participation in your Medicare or Medicare Advantage plan so you can have access to the doctors or hospitals you want to use. 

How to Get the Right Advice as You Make Your Choices

The Medicare Advantage plans in Missouri and specifically St. Louis are very robust. Now you have some information to help you make your choice of which type of plan to participate in. At MBhealth Insurance Agency, we are here to help you make your choices and explain all your options to you. Call us any time for friendly assistance: (314) 544-5400.

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