Original Medicare | Medicare Advantage (MA) | |
---|---|---|
What it covers | Original Medicare helps cover hospital and doctor visits. | MA plans bundle Part A and Part B benefits, and some include prescription drug coverage. Many MA plans also include routine dental, vision and hearing care—benefits not offered by Original Medicare. |
Maximum out-of-pocket cost guarantee | There is no maximum out-of-pocket cost guarantee with Original Medicare. | MA plans have a yearly limit on out-of-pocket costs for medical services, after which members pay nothing for covered services for the rest of the plan year. |
Doctors and hospitals | If you are enrolled in Original Medicare, you can go to any doctor or hospital in the U.S. that accepts Medicare. | MA plans generally require you to use doctors and facilities in the plan's network. If you see an out-of-network provider, your costs may be higher. |
Monthly premiums | You usually don't pay a monthly premium for Medicare Part A (hospital) coverage if you or your spouse paid Medicare taxes for a certain amount of time while working. You do need to pay a premium for Part B coverage. In 2025, the Medicare Part B premium is $185 or higher, depending on your income. | Many Medicare Advantage plans offer an affordable or $0 monthly plan premium. As with Original Medicare, Medicare Advantage members must continue to pay a monthly Part B premium ($185 in 2025), along with any MA plan premium. |
Deductibles and coinsurance | The 2025 Part A deductible for inpatient hospital coverage is $1,676. The 2025 annual deductible for Part B medical coverage is $257. | Deductibles and copays vary depending on the Medicare Advantage plan. |
Prescription drug coverage | Original Medicare does not include prescription drug coverage. You may choose to purchase a stand-alone prescription drug plan from a private company. | Most Medicare Advantage plans include coverage for prescription drugs, although there are also MA plans that cover medical services only. |
Can I change my plan if I don’t like it? | Yes. You can switch from Original Medicare to Medicare Advantage, or vice versa, each year during the | Yes. You can switch from Original Medicare to Medicare Advantage, or vice versa, each year during the |