Right off the bat: you’re probably asking, “Will my doctor still take me? Will my meds cost more? Am I going to pay more than I should?”
When you’re weighing original medicare vs medicare advantage, those questions matter more than plan names or shiny extras. Let’s walk through what Original Medicare really gives you, where it falls short—and when sticking with it (or switching out) makes sense.
What “Original Medicare” Includes (A & B)
What you’re really getting with Original Medicare (Parts A & B) is the federal “baseline” coverage everyone knows. Part A covers inpatient hospital care, short-term skilled nursing facility stays, hospice and select home health services, while Part B handles doctor visits, outpatient treatments, diagnostic tests, equipment like walkers or wheelchairs and preventive screenings.
With Original Medicare you benefit from broad acceptance by providers and a system you can count on—but it’s important to understand: this is the foundation, not the full house. There are still gaps in coverage you’ll need to address.
Why People Stay: Provider Freedom & Predictability with Medigap
Here’s what keeps folks anchored to Original Medicare:
-
Freedom to pick your doctor — If a doctor accepts Medicare, you can see them. No network hassles, no referrals required.
-
Flexibility if you travel or move — Original Medicare generally follows you nationwide (as long as the provider accepts Medicare).
-
Predictable structure — With the addition of a Medicare Supplement (Medigap) plus a Part D drug plan, you know what you’re buying: access + broad coverage + fewer surprises.
Costs with Medigap + Part D vs. an MA Plan
When you compare original medicare vs medicare advantage, the cost structure is very different:
-
With Original Medicare, you’ll pay Part B premiums (and Part A if you don’t qualify premium-free). Then you stack on a Medigap policy (to fill gaps) + Part D drug plan. That can mean higher premiums—but more predictable costs.
-
With a Medicare Advantage (MA) plan, premiums may be very low (even $0) beyond Part B, but you’ll face networks, rules, and varying copays or deductibles. MA plans often include Part D, which simplifies drugs—but you accept trade-offs.
Access, Referrals & Travel Considerations
If you travel often, spend part of the year in a second home, or simply value the freedom to see any doctor you choose, the “Original Medicare vs Medicare Advantage” decision takes on serious weight. With Original Medicare you’re not locked into a provider network—any doctor or hospital that accepts Medicare nationwide is open to you.
By contrast, Medicare Advantage plans typically operate within a defined network, may require referrals to see specialists, and could change cost sharing if you go out of your plan’s service area. That means if you’re away from your home region, you may find your access limited or your costs higher. If your lifestyle includes travel, multiple residences, or relying on a specific specialist, that provider-access freedom matters more than the way a plan is marketed.
Underwriting Considerations for Medigap (Outside Guaranteed Issue Windows)
If you go with Original Medicare + Medigap, keep this in mind:
-
You get a guaranteed-issue window when you first enroll in Part B (usually 6 months), during which Medigap insurers can’t charge more or deny you for health issues.
-
If you skip that window and later want Medigap, you may face medical underwriting—higher premiums or possible rejection.
So when comparing original medicare vs medicare advantage, remember: switching away from Original Medicare doesn’t mean you can always return to it with the same ease.
When Switching to MA Makes Sense
Switching to a Medicare Advantage plan may be the right move when:
-
You’re comfortable using a network of providers and the network includes your doctors.
-
You want extras (vision, dental, wellness) bundled in and value those additions.
-
Your drug, hospital and doctor usage is modest, and you’re okay trading some flexibility for potentially lower cost.
In other words, if the math works and the network fits—you may find MA is a fine fit.
Decision Checklist: Lifestyle, Doctors, Drugs, Budget
Here’s your quick decision checklist when comparing original medicare vs medicare advantage:
-
Do I want to keep my current doctors (and are they in MA networks)?
-
Do I travel, spend time in another state or need wide national access?
-
What are my medications, and how do they fit in MA formularies vs Part D plans?
-
What’s my budget worst-case if I use lots of care—hospital, specialists, big drugs?
-
Am I okay with referrals, networks and rules in exchange for lower premiums or bundled benefits?
-
Can I still get a Medigap plan later if I choose MA now (or be okay if I can’t)?
Work your answers honestly, and one path will stand out.
FAQs
What is a Medicare Advantage plan and how does it differ?
A Medicare Advantage plan (also called Part C) is offered by a private insurer as an alternative to Original Medicare. It must cover at least what Parts A and B do, but it typically includes drug coverage and may include extras—but also often comes with networks, prior-authorization rules and out-of-area limits.
When might sticking with Original Medicare make more sense than switching to Medicare Advantage?
If you value freedom to choose any provider, use multiple specialists, travel frequently or split time between homes, or want fewer rules (referrals & authorizations), then Original Medicare plus a supplement (Medigap) may be a better fit.
Is it true I can’t get a Medigap policy if I’m in a Medicare Advantage plan?
If you’re enrolled in a Medicare Advantage plan, you typically cannot purchase a new Medigap policy until you switch back to Original Medicare—and if you do, you may face health underwriting unless you qualify under a guaranteed-issue period.
How do I decide between Original Medicare and Medicare Advantage?
Start by asking: Who are my doctors? What drugs do I take? How often do I go to the hospital or see specialists? Then compare costs, network flexibility, travel needs and your comfort with rules. The right path depends entirely on your health, habits and budget.
Brickhouse Guidance for Either Path
At Brickhouse Agency, we don’t push one path over the other—we help you figure out which path fits you.
-
We’ll map your provider list, drug list and usage style.
-
We’ll compare Original Medicare + Medigap + Part D vs MA options side-by-side.
-
We’ll highlight trade-offs (cost, flexibility, risk) and help you pick the path you’ll be comfortable with—not just at signup but for years ahead. No jargon. No pressure. Just clarity and strategy.
Get a Personalized Path with Brickhouse
Not sure whether to stick with Original Medicare or switch to Medicare Advantage? Let’s walk through your options together and pick the plan that fits you. Schedule a free consultation and we’ll get started.
