The difference between private health insurance and Medicare is that Medicare is primarily for Americans age 65 and older and surpasses private health insurance in terms of the number of coverage options, while private health insurance covers dependents. Another important difference is that Original Medicare doesn't have an upper limit on out-of-pocket costs. That means there's no annual limit on how much you pay for your health care. Almost every other health insurance plan has this feature.
Medicare is federal health insurance for people age 65 and older and for some people under age 65 with certain disabilities or conditions. Medicare is managed by a federal agency called Centers for Medicare & Medicaid Services. As a federal program, Medicare has established cost and coverage standards. This means that a person's Medicare coverage will be the same no matter what state they live in.
Original Medicare is generally less expensive and more popular than private health insurance. You can use Medicare along with a private insurance plan to cover your out-of-pocket costs for your health care. Combinations of Medicare plans can create extended coverage similar to private coverage. Original Medicare (parts A, 26 B) and Medicare Advantage (part C) are two different ways to get Medicare benefits.
Both options offer the same basic level of medical and hospital insurance, but there are also important differences between them. It's important to know the differences in coverage, cost, and care provider rules, as they will affect how you decide which option is best for you. Read below to learn more about each of them in detail below. Original Medicare covers hospital and specialized nursing services for inpatients (Part A) and doctor visits, outpatient services, and some preventive care (Part B).
Medicare Advantage plans cover all of the above (Part A and Part B) and most plans also cover prescription drugs (Part D). In addition, each of the Medicare Advantage plans offers additional benefits that, while they vary by plan and provider, may include coverage for dental, eye care, fitness programs, trips to doctor's appointments, and more. Whether you choose the Original Medicare plan or a Medicare Advantage plan, you're likely to pay premiums, deductibles, copays, and coinsurance. One last key difference to consider when choosing between the Original Medicare plan and the Medicare Advantage plan are the health care providers you can go to.
With Original Medicare, you can go to any hospital and see any doctor or provider in the U.S. UU. However, it has limited coverage in foreign countries. With Medicare Advantage, most plans have a network of doctors and providers you can go to.
If you leave the plan's network, you may have to pay more to do so. However, emergency and urgent care is covered throughout the country. You also have limited coverage in foreign countries, although some plans may offer special coverage abroad or travel benefits. Medicare Advantage plans cover everything Original Medicare covers and more, so if you want dental, vision, or fitness benefits, a Medicare Advantage plan may be the best option.
Your total costs will vary depending on the coverage you choose and the health services you use. However, consider the following specifically when comparing which option best fits your financial situation. Original Medicare covers the care you get from any provider that accepts Medicare across the country. With most Medicare Advantage plans, you should consult the providers that are part of the plan network to avoid additional costs.
Network providers accept the negotiated plan prices so that you can take advantage of cost savings. If you travel a lot, consider how your Medicare coverage might work with this. As a final note, no matter which option you decide is right for you, you can switch from Original Medicare to Medicare Advantage or vice versa. The two main times when you can switch are the Medicare annual enrollment period and the Medicare special enrollment period for qualifying life events, if you qualify.
Medicare Made Clear, offered by UnitedHealthcare, provides information about Medicare so you can make informed decisions about your health and Medicare coverage. Improve your Medicare knowledge with reliable, up-to-date news and information delivered to your inbox every month. Enter your zip code for plans in your area. Original Medicare doesn't have drug coverage and requires you to take out private insurance, a Medicare Part D plan, or other qualifying private drug coverage if you want insurance coverage for your drugs.