How to Compare Original Medicare Part B to Medicare Advantage

Medicare offers its elderly and disabled beneficiaries two main choices: Medicare Part A and B, administered through the government; or the newer Medicare Advantage program, administered through private plans. Each program has its pros and cons, and comparing the two will help a consumer make an informed choice.

Fundamentals

• The federal government's Medicare program has two basic avenues: The original program encompassed two segments: Part A, for inpatient, or hospital insurance; and Part B, for outpatient "doctor visit" insurance. The newer Medicare Advantage program offers expanded Medicare benefits through a private-insurance option, at an extra cost.

Benefits

• Medicare Advantage plans provide all Part B benefits, which cover expenses incurred while in the hospital; as well as Part A benefits, which cover doctor visits, home health care, physical therapy and other non-hospital care. However, each Medicare Advantage may do so with restrictions that original Medicare plans don't have, such as prior authorization. Further, many Medicare Advantage plans offer benefits that Part B does not, such as dental and vision care and some medication coverage.

Price

• Original Medicare charges a monthly premium for Part B, as well as an annual deductible. Beneficiaries must also pay a coinsurance of 20 percent for most services. Medicare Advantage plans may charge a higher premium than the cost of Original Medicare Part B. Medicare Advantage plans usually charge a flat-rate copayment for services rather than a coinsurance charge.