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The two paths, side by side
| What matters | Original Medicare (Parts A and B) | Medicare Advantage (Part C) |
|---|---|---|
| Doctors and hospitals | Any provider nationwide that accepts Medicare | The plan's network; out-of-network care can cost more or not be covered |
| Referrals | Generally none needed for specialists | HMOs usually require a primary-care referral; PPOs usually do not |
| Prescription drugs | Needs a separate Part D plan | Normally included in the plan |
| Yearly out-of-pocket cap | None on its own (a Medigap policy can add protection) | A required annual cap on covered medical services |
| Dental, vision, hearing | Not part of standard coverage | Frequently included as an extra benefit |
| Monthly cost | The Part B premium, plus a Medigap and drug plan premium | The Part B premium, plus any plan premium the insurer charges |
Premiums and plan details are set each year and vary by county. Nothing here quotes your premium; a licensed agent can tell you the plans and prices where you live.
What tends to change each fall
- Drug coverage changes. Insurers re-tier their formularies every year. A medication that was cheap this year can move to a different tier. This is the single most common surprise, so read your plan's Annual Notice of Change and check every drug you take.
- Networks shift. Hospitals and physician groups renegotiate with insurers annually. A doctor who takes your plan this year is not guaranteed for next year. Call the office and ask.
- Extra benefits get reshuffled. Allowances, ride benefits and dental limits move up and down as insurers adjust their offerings.
Which path tends to fit whom
Original Medicare with a Medigap policy often suits people who travel or spend months in another state, see several specialists, or simply want to avoid network rules and referrals.
Medicare Advantage often suits people who want one card, a predictable ceiling on their yearly costs, and bundled dental, vision or wellness extras, and who are comfortable staying inside a regional network.
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