• Home
  • /
  • Blog
  • /
  • Compare Original Medicare & Medicare Advantage
October 17, 2023

When choosing between Original Medicare and a Medicare Advantage Plan for your health coverage, take these factors into consideration:

Medicare is a government-run health insurance program that provides coverage for hospital and medical services, while Medicare Advantage is a privately offered alternative that combines Medicare Parts A and B with additional benefits and often includes prescription drug coverage.

Doctor & hospital choice

Original Medicare

Medicare Advantage

In most cases you don’t need

referral to see a specialist.

You may need to get a referral to see a specialist.

You can go to any doctor or hospital that takes Medicare, anywhere in the U.S.

For non-emergency care, it is often necessary to use doctors and other providers who are within the network and service area of the plan in many cases.


Original Medicare

Medicare Advantage

After meeting your deductible, for Part B-covered services, you typically pay 20% of the Medicare-approved amount as your coinsurance.

The out-of-pocket costs for certain services can vary between plans, with some plans having lower or higher costs. Additionally, you may be required to pay an additional premium.

There is a monthly premium for Part B that you have to pay. If you decide to enroll in a Medicare drug plan, you will have to pay a separate premium for your Medicare drug coverage (Part D).

You are responsible for paying the monthly premium for Part B, and in addition, you may need to pay the premium for your specific plan. Certain plans have a $0 premium and may even assist in covering all or a portion of your Part B premium. Furthermore, most plans include Medicare drug coverage (Part D).

Unless you have supplemental coverage such as Medicare Supplement Insurance (Medigap), there is no annual limit on your out-of-pocket expenses.

For services that are covered by Medicare Part A and Part B, there is an annual out-of-pocket limit set by the plans. Once this limit is reached, you will not have to pay anything for the remaining covered services for the rest of the year.

To assist with covering your remaining out-of-pocket costs, such as the 20% coinsurance, you have the option to purchase Medigap. Alternatively, you can utilize coverage from a previous employer or union, or rely on Medicaid.

You can’t buy Medigap.


Original Medicare

Medicare Advantage

Original Medicare provides coverage for a wide range of medically necessary services and supplies in hospitals, doctors' offices, and other healthcare facilities. However, it does not cover certain benefits such as eye exams, most dental care, and routine exams.

Plans must cover all medically necessary services that Original Medicare covers. Plans may also offer some extra benefits that Original Medicare doesn't cover - like certain vision, hearing, and dental services.

You have the option to enroll in a standalone Medicare drug plan in order to obtain Medicare drug coverage (Part D).

Medicare drug coverage (Part D) is included in most plans. In most types of Medicare Advantage Plans, you can't join a separate Medicare drug plan.

In most cases, you don’t need approval for Original Medicare to cover your services or supplies

In many cases, you may need to get approval from your plan before it covers certain services or supplies.

Foreign travel

Original Medicare

Medicare Advantage

Original Medicare does not provide coverage for medical care received outside of the United States. However, you may be eligible to purchase a Medicare Supplement Insurance (Medigap) policy that includes coverage for emergency care received while outside of the U.S.

Plans generally don’t cover medical care outside the U.S. Some plans may offer a supplemental benefit that covers emergency and urgently needed services when traveling outside the U.S.

Original Medicare and Medicare Advantage coverage function in different ways, and choosing the right coverage option depends on your specific situation. To make an informed decision, it is advisable to seek help from a knowledgeable professional. Lehigh Partners Senior Benefits offers the expertise of their agents who can assist you in selecting the most suitable coverage choice for your needs. They can be reached conveniently through phone or online communication.

Get Help

Compare Medicare coverage options with the help of one of our agents:

Talk to us: (833) 265-9655 

Medicare brokers such as Lehigh Partners get paid by the insurance companies they represent. And you pay exactly the same rate for your insurance if you use a Medicare consultant (broker). There is no extra fee or cost for enrolling through a broker. You will never pay a fee for our help.

Find a Plan

Shop for coverage online. Safe, Secure, & Confidential

Call us

Call Lehigh Partners at 1-833-265-9655

Licensed insurance agents are available to help you through enrollment and beyond.

Need Help?

Get in touch with a licensed sales agent now by filling out the form - no obligations!

Medicare Checklist

Get Our FREE Medicare Checklist.

Download our complimentary Medicare checklist and conveniently access all the necessary information in one place, ensuring you never miss a crucial number, deadline, or date again.


General Medicare information, Medicare Advantage, Medicare Supplement, Part D RX Plans

As the population ages, there is an increasing need for specialized healthcare services catered towards seniors.

General Medicare information

Medicare insurance coverage is a critical component of healthcare planning for seniors in the United States.

General Medicare information

Sign up for Medicare Part A with this step-by-step guide. Learn about eligibility, enrollment periods, and

General Medicare information

Find the best Medicare rate for enrolling in a Medicare Supplement Plan any time of the

Medicare Advantage

Enrollment in Medicare Advantage has seen a significant increase of over 100% in the past decade.1.

General Medicare information, Health and Wellness, Medicare Advantage, Medicare Supplement, Part D RX Plans

Are you searching for the best Medicare insurance agency in Bethlehem? With a plethora of options

Medicare Advantage

A Medicare flex card helps cover health-related expenses like OTC medicine, dental copays, and more. It's

Ready to talk to an agent about your Medicare coverage?