There are a couple of options when choosing a Medicare plan: Original Medicare (parts A and B) and Medicare Advantage (Part C). A person may need to assess their individual needs and desires from coverage when making a decision.
When a person approaches 65 years old, at which point they can sign up for Medicare, they may wish to consider which plan will suit them and their needs best.
Making the right decision on which plan and packages to enroll in can help a person take some of the stress and expenses out of future medical treatment.
There are a few differences between Original Medicare and Medicare Advantage, the main ones being cost and coverage.
Cost
Original Medicare and Medicare Advantage may have different costs. This is generally because Original Medicare has costs that are set by the Centers for Medicare & Medicaid (CMS) and Medicare Advantage plans are provided by private insurance companies.
Original Medicare includes Part A (hospital insurance) and Part B (medical insurance). For most people, only Part B requires a monthly premium. However, many people choose to add a Part D plan for prescription drug coverage and Medigap to help with out-of-pockets costs. This can make the total monthly cost of Original Medicare higher than some Medicare Advantage plans.
Medicare Advantage, on the other hand, may have a lower premium but higher out-of-pocket costs. People with Medicare Advantage plans are required to pay the Part B premium in addition to their Medicare Advantage premium.
However, the cost of Medicare Advantage plans varies by geographical location.
Coverage
Medicare Advantage plans are required to provide the same coverage as Original Medicare (parts A and B). However, Medicare Advantage plans may also offer additional benefits that Original Medicare does not provide, such as:
- vision
- dental
- fitness programs
Medicare Advantage plans also typically include prescription drug coverage (Part D) as part of the plan. With Original Medicare, a person has to purchase a separate Part D plan from a Medicare-approved private insurance company.
Switching plans
A person can switch from Original Medicare to a Medicare Advantage plan or vice versa once per year during the open enrollment period, which falls from October 15 to December 7 each year. If they feel that a plan is not working well for them, they may be able to choose another Medicare option.
When comparing the costs of Original Medicare and Medicare Advantage, it is best to consider out-of-pocket costs alongside the monthly premium.
The following chart breaks down some of the basic costs in 2025 for these plans.
| Plan type | Monthly premium |
|---|---|
| Medicare Part A | These plans are free if a person qualifies. Otherwise, it is up to $518 per month. |
| Medicare Part B | The standard premium for these plans is $185 per month. However, they may cost more if a person has an income higher than $106,000 per year. |
| Medicare Part D | The cost varies by plan, but the estimated average premium in 2025 is $45, according to the non-profit KFF. |
| Medicare Advantage | As with Part D, the cost varies by plan. However, in 2025, the average monthly premium is estimated to be $17. |
Medicare Advantage plans have a maximum out-of-pocket limit (MOOP) that Original Medicare plans do not have. In 2025, the Medicare Advantage MOOP is $9,350.
Medicare supplement plans (Medigap) help a person cover some of the healthcare expenses associated with Original Medicare.
The CMS divides Medigap plans by letter. People new to Medicare in 2021 can choose from plans A, B, D, G, K, L, M, and N. However, not all insurers offer the same plans in all areas of the country.
Medigap plans can help cover several costs, including:
- copayments for parts A and B
- up to 3 pints of donated blood
- coinsurance for skilled nursing facilities
- yearly out-of-pocket expenses
People with Original Medicare who have concerns about out-of-pocket expenses may choose a Medigap plan. A person cannot have a Medicare Advantage plan and a Medigap plan at the same time.
Medicare resources
For more resources to help guide you through the complex world of medical insurance, visit our Medicare hub.
People who are eligible for Medicare may wish to consider cost and coverage when choosing a Medicare plan.
The cost of Original Medicare and Medicare Advantage can vary based on several factors. While Medicare Advantage plans are required to offer the same coverage as Original Medicare, they may also offer additional benefits Original Medicare does not provide.
