Original Medicare vs. Medicare Advantage: How do they compare?

Oct. 4, 2023

A growing number of people – nearly half of eligible Medicare beneficiaries – choose Medicare Advantage for their Medicare coverage.

So, what’s the difference between Original Medicare and Medicare Advantage? Check out this chart for a helpful overview.

Read: Beneficiaries in Medicare Advantage Receive Better Value and Spend 45% Less than Beneficiaries in Medicare FFS

Nearly 30 million people choose Medicare Advantage for their health care coverage. Learn more about Medicare and the value this program delivers.

Original Medicare	vs.	Medicare Advantage
Federal government	Who offers the coverage	Medicare-approved private insurance companies
Original Medicare includes Part A and Part B. Part A: Inpatient care in hospitals and skilled nursing facilities Hospice care and some home health care Part B: Doctor visits Outpatient hospital services Durable medical equipment Preventive services	What it covers	Medicare Advantage combines your hospital (Part A) and doctor visits (Part B) into one plan and often includes prescription drug coverage (Part D). Plans can also offer additional benefits and programs Original Medicare doesn’t cover, like: Routine vision, hearing and dental care Credits for over-the-counter products Gym memberships Disease management programs 24/7 access to health care professionals Rewards for healthy behaviors
Part A is free for most people. The standard monthly premium for Medicare Part B enrollees is $164.90 in 2023; 2024 premiums will be determined later this year. Medicare also charges deductibles, copays and coinsurances.	What it costs	Each Medicare Advantage plan sets its own premium, with many offering a $0 premium in addition to your Medicare Part B premium. Plans have predictable copays and coinsurances.
No. Generally speaking, Part B covers about 80 percent of a person’s health care costs, leaving them to cover the remaining 20 percent out of pocket.	Annual cap on out-of-pocket expenses	Yes. Medicare Advantage plans set an annual out-of-pocket maximum to help limit how much you may have to pay for health care services each year. The limit depends on the plan but can’t be more than $8,850 in-network in 2024.

Original Medicare vs. Medicare Advantage: How do they compare?

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