Original Medicare Medicare Advantage What it is
  • Administered by the federal government
  • Includes Part A (hospital insurance) and Part B (medical insurance) benefits
  • Administered by private insurance companies, such as Humana
  • Called Part C
  • Includes Part A (hospital insurance) and Part B (medical insurance) benefits and additional features and benefits
What it covers
  • Hospital and doctor visits
  • Hospital and doctor visits
  • Many plans also offer coverage for prescription drugs and/or dental, vision and hearing care services
Maximum out-of-pocket cost
  • No guaranteed limit to maximum out-of-pocket costs
  • Adding a Medicare Supplement insurance policy can help cover certain out-of-pocket costs (like deductibles and copays)
  • Guaranteed maximum yearly limit on out of pocket costs for covered medical services
  • Once that limit is reached, there is no charge for covered services for the rest of the plan year
Doctors and hospitals
  • Freedom to visit any doctor or hospital in the U.S. that accepts Medicare patients
  • Emergency care covered at any facility
  • Cost of services will be generally lower at network doctors and hospitals
  • Typically there is no monthly premium for Medicare Part A for people who paid Medicare taxes while working
  • In 2021, the Part B premium is $148.50 or higher depending on your income.
  • Many plans offer a low or $0 monthly plan premium
  • Part C members must continue to pay the Part B monthly premium*
Deductibles and coinsurance
  • The 2021 Part A deductible for inpatient hospital coverage is $1,484.00
  • The 2021 annual deductible for Part B is $203.00
  • These will vary, depending on the location, Part C plan selected and the insurance provider
  • Each plan usually has a fixed deductible and/or coinsurance amount
  • Cost-share will typically be higher for visiting non-network providers
Prescription drug coverage
  • Original Medicare does not include prescription drug coverage
  • Most Part C plans include coverage for prescription drugs
Plan choice flexibility
  • Not Applicable
  • Option to change the plan each year during the Annual Election Period, which runs from Oct. 15–Dec. 7
*The Medicare Part B premium in 2021 is $148.50 per month or higher depending on your income.