Medicare Advantage or Original Medicare? 4 Questions to Help You Choose a Medicare Plan That Is Right for You

The average person makes about 35,000 decisions each day. Some of these decisions are easy: Chicken or fish for lunch? Paper or plastic at the supermarket?

Other decisions aren’t that simple. Choosing whether you get your Medicare benefits from Original Medicare or Medicare Advantage can be a little more complicated. The following 4 questions may help you choose the best Medicare plan for your needs.

1. Will my budget allow for some unknown expenses?

Medicare Advantage limits your out-of-pocket expenses for covered medical services. Original Medicare has no such limit. (Enter: the unknown!) Your out-of-pocket expenses may continue for as long as you require treatment. This introduces some uncertainty into your health care budget, not to mention your peace of mind. After all, no one can predict the future.

Medicare Advantage may limit how much you’ll pay out-of-pocket in a year, but the added peace of mind may come at a higher price for premiums, reports Bankrate.

2. Is it okay if I’m limited in my choice of doctors?

Medicare Advantage restricts your choice of doctors by contracting with a network of providers, adds Bankrate. Original Medicare allows you to visit any physician that accepts assignment.  Since Original Medicare is widely accepted, there’s a very good chance that you can visit doctors you already know.

3. How important is convenience to me?

Medicare Advantage’s suite of coverage can make it easier to navigate the confusing waters of today’s healthcare market. Original Medicare requires a more involved approach.

For example, Original Medicare does not cover all your expenses, and many people find the need for supplemental insurance called Medigap to help cover them. That’s great, but now you have two separate plans. And if your spouse also carries Original Medicare and Medigap? How many plans are you juggling now? As you can see, the potential for headaches can increase with each additional part.

4. How concerned am I about paying for prescription drugs?

Philip Moeller is a Medicare expert and author. In an interview with Bloomberg, he shared a story about a friend’s view toward Medicare Plan D, which provides prescription drug coverage.

Until recently, he didn’t have a Medicare Part D drug plan because he didn’t take any expensive medications, so figured he didn’t need it. He’s now recognized that the drug coverage is a wonderful catastrophic insurance policy against these very wonderful but very expensive new medications that odds are more and more of us will need to take when we get old.

Part D is included in most Medicare Advantage plans, but is optional and you would have to enroll in a Prescription Drug Plan separately if you have Original Medicare. When choosing between Medicare Advantage or Original Medicare, it may help to consider how much you currently rely on medications and how that could change in the future. If you do not sign up for Part D coverage when you are first eligible, you may incur a late enrollment penalty if you decide to enroll later on.

I’m ready to take the next step!

According to the Kaiser Family Foundation, more enrollees select Original Medicare (about 69 percent) over Medicare Advantage (31 percent). With so many variables, however, it isn’t easy to decide which plan is best for you. Answering these 4 questions is a good start.

When you’re ready to take the next step, Direct Auto Insurance is here to help you choose the best health insurance for your needs. Call a licensed agent at 1-844-961-9453 – TTY 711 with your Medicare questions, or visit our favorite Medicare experts online at Medicare.org* to compare health coverage plans.

Standard call center hours of operation are Monday – Friday 5:00 a.m. to 6:00 p.m. PT. During Medicare’s Annual Enrollment Period (AEP), extended hours are Monday – Saturday 5:00 a.m. to 8:00 p.m. PT.

*Medicare.org is a non-government site and is operated by HealthCompare Insurance Services, a licensed health insurance agency certified to sell Medicare products. It contains information about and access to insurance plans for Medicare beneficiaries, individuals soon eligible for Medicare and those advising on behalf of Medicare beneficiaries. Medicare.org is not endorsed by the Centers for Medicare & Medicaid Services (CMS), the Department of Health and Human Services (DHHS), or any other government agency. If you’re looking for the government’s Medicare site, please navigate to www.medicare.gov. HealthCompare Insurance Services, Inc. is a licensed and certified representative of Medicare Advantage HMO, PPO and PFFS organizations and Medicare Prescription Drug plans with a Medicare contract. Enrollment in any plan depends on contract renewal. The purpose of this communication is the solicitation of insurance. Contact will be made by an insurance agent/producer or insurance company. Limitations, copayments, and restrictions may apply. Benefits, premium and/or copayments/coinsurance may change on January 1, of each year. The plans we represent do not discriminate on the basis of race, color, national origin, age, disability, or sex.