If you’re approaching 65 or are eligible for Medicare due to a disability, you’ve likely heard about Medicare Advantage—also called Medicare Part C. But what exactly is it, and how does it differ from Original Medicare? Let’s break it down.

Medicare Advantage is a way to get your Medicare benefits through private insurance companies approved by Medicare.

These plans cover everything Original Medicare (Parts A and B) covers, including:

• Hospital care (Part A)
   
• Doctor visits, outpatient services, and preventive care (Part B)
   

But that’s not all. Most Medicare Advantage plans also offer some extra benefits not included in Original Medicare, such as:

• Prescription drug coverage (Part D)
   
• Some Limited Dental, vision, and hearing care
   
• Fitness programs and wellness perks
   
• Transportation to medical appointments
   

When you enroll in a Medicare Advantage plan:

• You continue to pay your Medicare Part B premium.
   
• Some plans charge an additional monthly premium.
   
• Most plans have a network of doctors and hospitals; visiting providers outside the network can cost more or, in the case of an HMO, not covered at all.
   
• Some plans require referrals to see specialists.
   

Basically, the private insurer manages your Medicare benefits, while still following Medicare’s rules.

Medicare Advantage plans often make healthcare costs more predictable. You can expect:

• Monthly premiums: Your Part B premium plus any plan-specific premium
   
• Copayments or coinsurance for services
   
• Maximum out-of-pocket limit: Once you reach it, the plan covers 100% of covered services for the rest of the year
   

This maximum out-of-pocket limit is one major advantage over Original Medicare, which doesn’t have a cap.

There are several types of plans to suit different needs:

• HMO (Health Maintenance Organization) – Must use the plan’s network; referrals often required
   
• PPO (Preferred Provider Organization) – Can see out-of-network doctors at a higher cost
   
• SNP (Special Needs Plan) – Designed for people with specific health conditions
   
• Other variations – Include PFFS (Private Fee-for-Service) and MSA (Medical Savings Account) plans
   

Choosing between Medicare Advantage and Original Medicare comes down to priorities:

• Medicare Advantage: Offers extra benefits, predictable costs, and a maximum out-of-pocket limit—but may restrict which doctors you can see.
   
• Original Medicare: Offers flexibility to see almost any doctor or hospital—but may require supplemental insurance to cover gaps and has no out-of-pocket maximum.
   

Medicare Advantage is great if you want:

• Added benefits like prescription drug coverage, dental, or vision
   
• Predictable costs with a maximum out-of-pocket limit
   
• A plan that bundles multiple benefits into one
   

Original Medicare may be better if:

• You want freedom to choose any doctor or hospital
   
• You travel frequently and need nationwide coverage
   
• You prefer to buy supplemental insurance for coverage gaps, which pays your Medicare Part A deductibles and Part B co-insurance automatically
   

Medicare Advantage is a convenient, all-in-one alternative to Original Medicare, especially if you value extra benefits. If Freedom to choose your own doctors and hospitals is important to you, and you would rather pay a premium to cover your Part A deductible and the 20% automatically, and a Premium for your Part D drug plan, then Original Medicare might be your choice. But it’s important to review the plans available in your area, check the provider networks, and consider your personal healthcare needs before enrolling.