How to Choose Between Medicare Advantage and Original Medicare in Missouri

Choosing between Medicare Advantage (Part C) and Original Medicare (Part A & B) is a major decision for Missouri residents, as it impacts your healthcare coverage, out-of-pocket costs, and provider options. Understanding the key differences between these two options will help you make an informed choice that best meets your healthcare needs.

Original Medicare (Part A & B)

  1. Coverage:

    • Part A (Hospital Insurance): Covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health services. Part A is free for most people if they have worked and paid Medicare taxes for at least 10 years.

    • Part B (Medical Insurance): Covers outpatient services, such as doctor visits, lab tests, X-rays, and preventative services like vaccines. Part B requires a monthly premium, which can vary depending on income.

  2. Costs:

    • While Part A is usually free for most people, Part B involves a monthly premium. Additionally, you’ll be responsible for deductibles, coinsurance, and copayments for services covered under Original Medicare.

    • Some people opt for Medigap (Medicare Supplement Insurance) to help cover out-of-pocket costs, such as deductibles and coinsurance. Medigap policies are sold by private insurers and can offer extra coverage beyond what Original Medicare provides.

  3. Flexibility:

    • One of the main benefits of Original Medicare is its flexibility. With Original Medicare, you can see any doctor or specialist who accepts Medicare, regardless of location. This makes it a great option for those who travel frequently or live in rural areas.

Medicare Advantage (Part C)

  1. Coverage:

    • Medicare Advantage plans are provided by private insurance companies approved by Medicare. These plans combine the coverage of Part A, Part B, and usually Part D (prescription drug coverage) into a single plan. Many Medicare Advantage plans also offer extra benefits such as dental, vision, hearing, and wellness services.

  2. Costs:

    • The monthly premium for a Medicare Advantage plan is typically lower than that of Medigap or Original Medicare, but there may be additional out-of-pocket costs for copays and coinsurance. Many plans have a network of doctors and healthcare providers, which can limit your choice of healthcare professionals.

    • It's important to review each plan's network, premiums, and out-of-pocket costs to ensure the plan fits your needs.

  3. Flexibility:

    • Medicare Advantage plans typically come with more restrictions compared to Original Medicare. These plans may require you to use a network of doctors, and you might need a referral to see a specialist. However, they may be a good choice if you want extra benefits and are comfortable with a network-based plan.

Which Option Is Right for You?

  • Original Medicare is ideal if you value flexibility and don’t mind dealing with multiple insurers for different parts of your healthcare needs.

  • Medicare Advantage might be the right choice if you want all-in-one coverage with additional benefits like dental, vision, and hearing, but are willing to use a network of providers and handle some co-pays.

Contact Us

At Riverside Insurance Professionals, we’re here to guide you through the Medicare process in Missouri. Our licensed agents are ready to answer your questions and help you select the best plan. If you need assistance, feel free to reach out:

  • Phone: (573) 535-6044

  • Email: Jennifer@riversideinsuranceprofessionals.com

  • Office Hours: Monday – Friday, 9:00 AM to 5:00 PM

For additional official Medicare resources, visit the Medicare Eligibility & Enrollment page on Medicare.gov.

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