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Medicare is a federal health insurance program for people who are 65 or older, disabled, or have certain chronic conditions. Medicare has two main ways to provide coverage: traditional Medicare and Medicare Advantage¹². Deciding between traditional Medicare or Medicare Advantage depends on several factors, such as your health care needs, preferences, budget, and location. Here are some of the main differences and similarities between the two options: Traditional Medicare: This option is the original government system that has been in place since 1966; that’s why it’s also called original Medicare. It comprises Parts A and B, and it works on a fee-for-service basis. Part A covers inpatient hospital care, skilled nursing facility care, hospice care, and some home health care. Part B covers doctor’s visits, preventive services, durable medical equipment, and other outpatient services. You can go to any doctor or hospital that accepts Medicare, anywhere in the U.S. You usually pay a monthly premium for Part B and a deductible and coinsurance for both Part A and Part B services. There is no limit on your out-of-pocket costs unless you have supplemental coverage, such as a Medigap policy or Medicaid¹²³. Medicare Advantage: Medicare Advantage is the name used collectively for Medicare’s private health plans. These plans are offered by private insurance companies that contract with Medicare to provide Part A and Part B benefits. They are also known as Part C or MA plans. Most Medicare Advantage plans also include prescription drug coverage (Part D), as well as extra benefits that traditional Medicare does not cover, such as dental, vision, hearing, wellness programs, and care coordination. You usually pay a monthly premium for your Medicare Advantage plan, in addition to your Part B premium. You may also pay deductibles, copays, or coinsurance for the services you use. However, Medicare Advantage plans have a limit on your out-of-pocket costs for Part A and Part B services each year. Once you reach that limit, you pay nothing for those services for the rest of the year. You typically have to use doctors and hospitals that are in your plan’s network and service area (except for emergencies), and you may need a referral from your primary care provider to see a specialist¹²³. Some of the advantages of traditional Medicare are: •It gives you more flexibility and choice in selecting your providers and facilities •It does not require referrals or prior authorizations for most services •It covers you anywhere in the U.S., as well as in some foreign countries •It allows you to buy a Medigap policy to help pay your out-of-pocket costs •It does not change its benefits or costs from year to year Some of the disadvantages of traditional Medicare are: •It does not cover prescription drugs (unless you buy a separate Part D plan) •It does not cover many services that may be important to you, such as dental, vision, hearing, or long-term care •It does not cap your out-of-pocket costs for Part A and Part B services •It may charge higher premiums, deductibles, or coinsurance than some Medicare Advantage plans •It may require you to pay more if you use providers that charge more than the Medicare-approved amount Some of the advantages of Medicare Advantage are: •It covers prescription drugs and other benefits that traditional Medicare does not cover •It limits your out-of-pocket costs for Part A and Part B services each year •It may charge lower premiums, deductibles, or coinsurance than traditional Medicare •It may offer care coordination and wellness programs to help you manage your health •It may change its benefits or costs from year to year to better suit your needs Some of the disadvantages of Medicare Advantage are: •It restricts your choice of providers and facilities to those in your plan’s network and service area •It may require referrals or prior authorizations for some services •It does not cover you outside of the U.S., except for emergencies •It does not allow you to buy a Medigap policy to help pay your out-of-pocket costs •It may have different rules or restrictions than traditional Medicare •There is no one-size-fits-all answer to whether traditional Medicare or Medicare Advantage is better for you. You should compare different plans and options based on your personal situation and preferences. You can use online tools or resources from Medicare.gov or other sources to help you make an informed decision¹²³..