How many enrolled in each option?
About 60% of enrollees in original Medicare and 40% in Medicare Advantage.
What are the joining processes for each option?
Original Medicare: beneficiaries sign up for part A and part B directly with Medicare, and purchase part D directly from private insurers.
Medicare Advantage: an enrollee needs to first sign up for Medicare part A and part B with the government in order to receive the Medicare card. Then fill out an enrollment form with the plan in Medicare Advantage to join.
Any restrictions in each option?
In original Medicare, you may choose any doctor or hospital that accepts Medicare.
In Medicare Advantage, you have to use doctors and hospitals in its networks in order to be covered.
How about costs for each option?
For original Medicare, the government adjusts premiums, deductibles, and copays that apply to all enrollees nationwide. You are responsible for 20% of health bills.
For Medicare Advantage, private plans also adjust premiums, deductibles, and copays annually, so you need to review each autumn when adjustments are announced. Generally these plans have lower copays and out-of-pocket costs than original Medicare.
Any coverage differences for these two options?
The original Medicare pays for most basic medical needs but has some gaps (see first blogpost's discussion).
The Medicare Advantage coves everything original Medicare does, some plans also cover dental, vision and hearing, as well as prescription drug costs. Some also provide services such as transportation, home-delivered meals and health-related home improvements.
In next blogpost, we will summarize which option best fits for what kind of enrollees.