What’s Better – Medicare Basic or Medicare Advantage?

Health insurances are an important part of our lives. You can’t deny that. But everyone cannot afford health insurance that costs them more than the usual. So, choosing an insurance plan that fits in your pocketbook along with providing a good service is crucial. In this article, you’ll get to know which plan is better, Medicare basic or Medicare advantage. Let’s dive into it!

What Is Medicare Basic Plan?

The federal government directly provided the basic plan, hence no pre-existing terms (such as waiting periods, etcetera).

The basic plan comprises of two parts; A and B. The part A benefits are premium-free for almost everyone having a work history. Part B also has the same standard rate for 95% of the people, except the 5% high earners who pay an income-related adjusted rate.

Benefits

Under the Medicare basic plan, you can access any healthcare provider who accepts the Medicare plans. This means that you can choose anyone among thousands of health care providers. The payment remains the same, regardless of the doctor you choose. 

Let’s now talk about what the two parts of the basic plan cover.

Part A: Care during the period you’re admitted in a hospital or nursing home, hospice care, home-based health care, and other inpatient healthcare needs.

Part B: Healthcare services including visits of the healthcare provider, X-rays, laboratory tests, medical equipment like wheelchairs, oxygen tanks, and other such expenses of the patient.

Unluckily, you don’t get the drug coverage in the basic plan. However, you can apply for a private plan to cover the drugs part for you.

Part D: The drug insurance. This is provided by private companies that cover up the minimum needs of the Medicare basic plan.

What Is Medicare Advantage Plan?

Medicare advantage plan has been a powerful alternative for older adults since it was given out in 2003. Today, almost 1/3 of all healthcare beneficiaries enrol in this plan.

So, what is this plan about? You can refer to this plan as Part C of the Medicare basic plan. The ground reason is still the provision of healthcare services, but private companies administer this plan. Therefore, every advantage plan has a different choice of doctors. The drug formulas may also vary in this plan. 

Common Types:

Health Maintenance Organizations: This type of advantage plan requires you to choose a primary doctor who oversees your medical conditions. A referral may be needed if you want to choose a specialist or any additional screenings/operations. The drug plan is covered in almost all the HMO’s.

Preferred Provider Organizations: As the name suggests, you can go to any doctor who accepts the Medicare plan without choosing a primary doctor. Most of these PPO plans cover Part D too. 

What’s the Difference?

Every plan, whether it’s basic or an advantage, has to offer all the healthcare services. However, some Medicare advantage plans go beyond the regular plans and offer additional pros, such as dental care, routine check-ups, etcetera.

Medicare basic plan includes your payment for plan A and B, in addition to your other chosen plans such as Medigap or Medicare advantage. The advantage plan will only ask you to pay for part C and cover the bills for parts A and B.

Can Advantage Plan Replace Basic Plan?

It can’t; although the advantage plan covers pretty much a lot, you still need to enrol in parts A and B. So, the term replacement can be misleading. You can say Advantage adds up to the pros for the basic plan, but it doesn’t cover basic plan parts.

What’s Better, and Why?

Medicare Basic: The four appealing things regarding these plans are; a given cost, freedom to choose doctors, freedom to choose specialists (without referrals), and sometimes the doctor. 

It will be excellent for people who travel a lot and those who want to get complete flexibility regarding doctors’ choice.

Medicare Advantage: This plan doesn’t have a standard rate; you pay for what you consume. So, you’ve to pay only for the premium healthcare services you opted for. These plans are top-grade for people who don’t need to see a doctor now and then. 

Reach out Today at NewMedicare.