Is Traditional Medicare or Medicare Advantage Right for Me?

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What’s the difference.

When you turn 65, you become eligible for Medicare health insurance.
You will choose between Traditional Medicare and Medicare Advantage:

Understanding Traditional Medicare: Coverage and Structure

Health coverage with monthly premiums and some out-of-pocket costs, which can be significantly reduced with a supplemental Medigap plan. There is no premium for hospital care (Part A) and separate premiums for doctors’ office care (Part B) and prescription drugs (Part D).

Most doctors, hospitals, and specialists accept this insurance, and there are typically no prior authorizations or insurance approvals required before you can receive care.

Key Considerations

More flexibility when choosing your doctors, hospitals, and medical procedures.
Rarely denies medically necessary care if it’s provided by a healthcare professional who accepts Medicare.
If you are eligible for both Medicare and Medicaid, you are better off with Traditional Medicare than Medicare Advantage because Medicaid covers your out-of-pocket costs.

Understanding Medicare Advantage: Coverage and Structure

Health coverage by a commercial health insurance provider that bundles your different types of coverage into one health plan and premium. Prescription drug coverage is included.

You may be restricted on which doctors, hospitals, and specialists you can visit and may be required to get a prior authorization or approval from your insurance company before you can receive care.

Some plans offer coverage for vision, hearing, and/or dental.

Key Considerations

Plans sometimes offer additional benefits, gym memberships, and wellness programs.
Restricts which doctors and hospitals you can see.
Can deny certain types of care or payment for care even if your doctor says it’s necessary.
May save healthy people money on monthly costs but may have higher out-of-pocket expenses when you need care.