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Traditional Medicare vs Medicare Advantage vs Medicare Part D vs Medicare Supplement Explained
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Traditional Medicare Consists of Part A for Hospital Coverage and Part B for Physician and Outpatient Services Coverage (e.g. lab, imaging).
Traditional Medicare Has a Low Premium that Must be Paid by the Beneficiary and Part B has Both a Deductible and 20% Co-Insurance with NO Out-of-Pocket Maximum.
Medicare Advantage Includes Hospital Coverage, Physician Coverage, Outpatient Services Coverage AND Prescription Coverage and Frequently Dental Coverage, Vision Coverage and Hearing Coverage.
Medicare Advantage Premiums are Low and Can Even Be $0.
However, Most Medicare Advantage Plans are Either an HMO with a Primary Care Gatekeeper or a Narrow-Network PPO Plan with Fewer Choices in Doctors and Hospitals than Traditional Medicare.
Additionally, Traditional Medicare Does Not Require a Referral to See a Specialist and There are No Prior Authorization, BUT Medicare Advantage Plans Frequently DO Require a Referral and Have Prior Authorization Requirements.
Medicare Part D Provides Prescription Drug Coverage for Beneficiaries Who are on Traditional Medicare.
Medicare Supplement Insurance is Optional Insurance that a Beneficiary Can Buy to Cover the Expenses Not Covered by Traditional Medicare, Such as the 20% Co-Insurance for Outpatient Services.
Sources:
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Traditional Medicare Has a Low Premium that Must be Paid by the Beneficiary and Part B has Both a Deductible and 20% Co-Insurance with NO Out-of-Pocket Maximum.
Medicare Advantage Includes Hospital Coverage, Physician Coverage, Outpatient Services Coverage AND Prescription Coverage and Frequently Dental Coverage, Vision Coverage and Hearing Coverage.
Medicare Advantage Premiums are Low and Can Even Be $0.
However, Most Medicare Advantage Plans are Either an HMO with a Primary Care Gatekeeper or a Narrow-Network PPO Plan with Fewer Choices in Doctors and Hospitals than Traditional Medicare.
Additionally, Traditional Medicare Does Not Require a Referral to See a Specialist and There are No Prior Authorization, BUT Medicare Advantage Plans Frequently DO Require a Referral and Have Prior Authorization Requirements.
Medicare Part D Provides Prescription Drug Coverage for Beneficiaries Who are on Traditional Medicare.
Medicare Supplement Insurance is Optional Insurance that a Beneficiary Can Buy to Cover the Expenses Not Covered by Traditional Medicare, Such as the 20% Co-Insurance for Outpatient Services.
Sources:
AHealthcareZ is 200+ Healthcare Finance Educational Videos.
AHealthcareZ Viewers Include: Employee Benefits Professionals, HR, CFOs, Insurance Brokers, Benefits Consultants, Doctors and Nurses in Leadership Roles, Hospital and Health System Administrators, Health Insurance Carrier and PBM Professionals, Pharma and Med Device Professionals, Academic Professors and Students in Healthcare Administration and Public Health.
90,000+ Views Per Month Across All Platforms.
Visit AHealthcareZ.com to Subscribe to the Healthcare Finance Video Newsletter.
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