Medicare Advantage vs. Original Medicare: Which One Saves You More?

What Is Original Medicare?

Original Medicare is the traditional government-run program. It includes:

• Medicare Part A: Hospital insurance (inpatient care, hospice, skilled nursing facility care).
• Medicare Part B: Medical insurance (doctor visits, outpatient services, preventive care, and durable medical equipment).

With Original Medicare, you can see any doctor or specialist in the U.S. who accepts Medicare — there are no networks. This gives you maximum flexibility.

But there’s a catch: Original Medicare only covers 80% of your medical costs. That leaves you responsible for the remaining 20% unless you get a Medigap (Supplement) plan.

Also, Original Medicare does not include prescription drug coverage, so you’ll need to enroll in a standalone Part D drug plan. It also doesn’t cover dental, vision, or hearing, so many people purchase those policies separately.

What Is Medicare Advantage?

Medicare Advantage (Part C) is an all-in-one alternative to Original Medicare, offered by private insurance companies. These plans bundle Part A and Part B and often include:

• Part D (prescription drug coverage)
• Dental, vision, and hearing benefits
• Gym memberships and wellness perks

Many Medicare Advantage plans have $0 monthly premiums, but you still have to pay your standard Part B premium to Medicare.

Key Differences Between Original Medicare and Medicare Advantage

Feature	Original Medicare	Medicare Advantage
Provider Access	Any Medicare-accepting provider nationwide	Must use plan network (HMO/PPO)
Referrals Needed	No	Often required for specialists
Drug Coverage	Not included (requires Part D)	Often included
Dental, Vision, Hearing	Not included	Often included
Monthly Premium	Part B + Medigap + Part D	Typically just Part B
Out-of-Pocket Costs	Predictable with Medigap	Copays vary; high max out-of-pocket possible

Pros and Cons

Original Medicare + Medigap Pros:

• Flexibility to see any doctor or specialist nationwide
• Predictable out-of-pocket costs
• Comprehensive coverage with Medigap Plan G or Plan N

Cons:

• Higher monthly premiums (Part B + Medigap + Part D)
• No built-in dental/vision coverage

Medicare Advantage Pros:

• Lower monthly premiums (often $0)
• Extra benefits (dental, vision, hearing, fitness)
• All-in-one convenience

Cons:

• Limited networks (must use in-network providers)
• Potentially high out-of-pocket costs (up to $8,000/year)
• Coverage, costs, and networks can change every year

Which One Will Save You More?

That depends on how you use healthcare and what kind of peace of mind you want.

Choose Original Medicare + Medigap if:

• You want freedom to see any provider
• You prefer predictable medical expenses
• You’re managing chronic conditions or expect more healthcare usage

Choose Medicare Advantage if:

• You want low or no premiums
• You’re okay with using a network and paying copays
• You’re relatively healthy and want some extras like dental or gym memberships

Important Tip: Switching Isn’t Always Easy

If you start with Medicare Advantage and later want to switch to Original Medicare + Medigap, you may have to go through health underwriting — and you could be denied coverage.

This is why your initial decision is so important. In some cases (like during Special Enrollment Periods), you can switch without answering health questions, but these are limited windows.

How We Help You Decide

At Bluewave Insurance, we help you:

• Compare Medicare Advantage vs. Original Medicare plans side-by-side
• Review your current health needs and provider preferences
• Understand the long-term costs of both types of coverage

And we do this every year during the Annual Enrollment Period (October 15 – December 7) to make sure you’re on the best plan for your needs and budget.

Final Thoughts

There’s no one-size-fits-all answer when it comes to Medicare Advantage vs. Original Medicare. It’s all about your personal situation, your doctors, and how much risk you’re comfortable with.

But one thing’s for sure — making the wrong choice could cost you thousands.

Let us help you make the right decision. Our services are 100% free, and we’ve helped thousands of people nationwide find the right Medicare plan.

Call us today at 800-208-4974 to schedule a free consultation.