Why is regular Medicare better than an advantage plan?
Answered by 73 licensed agents
Reasons why Original Medicare is often preferred include: 1. Freedom to See Any Doctor Nationwide. With Original Medicare, you can see any doctor or hospital in the U.S. that takes Medicare, no networks, no referrals. With Medicare Advantage, you’re limited to the plan’s network, and going out-of-network can mean big bills or no coverage at all; 2. Guaranteed Coverage for Medically Necessary Care; Original Medicare covers medically necessary care as defined by federal law. Medicare Advantage plans can require prior authorization, meaning the plan must approve before you get care.
This can delay or deny treatments; 3. No “Surprise” Network Changes. Doctors and hospitals can leave an Advantage network anytime during the year. With Original Medicare, as long as the provider accepts Medicare, you’re covered; 4. Easier When Traveling or Moving; Original Medicare works anywhere in the U.S.
Medicare Advantage plans are local/regional, move or travel, and your plan may not cover you. 5. Predictability with Medigap
If you add a Medigap supplement, your out-of-pocket costs with Original Medicare can be very low and predictable. Advantage plans have lower premiums up front, but if you get really sick, you could face thousands in costs (up to $8,850 per year in 2025, not including drugs).
The tradeoff is that Medicare Advantage = lower monthly costs, extra perks, managed care (but with restrictions). Original Medicare = more freedom, broader coverage, stronger protections (but you’ll likely pay more monthly if you add Medigap + Part D). Many people who value choice of doctors and fewer hassles prefer Original Medicare.
Answered by Otumdi Omekara on September 24, 2025
Broker Licensed in OR, AZ, FL, MI & NV
Here’s why:
Go anywhere, see anyone
With Original Medicare, you can see any doctor or hospital in the U.S. that accepts Medicare — no referrals, no network restrictions. Traveling? Snowbird? Second opinion at the Mayo Clinic? You're covered coast-to-coast.
Access to the best care
Many of the top-rated hospitals — like MD Anderson, Mayo Clinic, Cleveland Clinic, and Sloan Kettering — don’t contract with Medicare Advantage plans or only take a few. With Original Medicare, your options stay open.
No insurance company gatekeeping
Your care decisions stay between you and your doctor — not a health plan deciding whether your treatment is “approved.” No prior authorizations for every test or scan. You and your physician are in charge.
It’s the Cadillac of health coverage
When you pair Medicare with a Supplement (like Plan G), it’s one of the most comprehensive health insurance options in the U.S. Most medical services are fully covered, with little to no out-of-pocket costs and no surprises.
Bottom line: If you value flexibility, top-tier access, and long-term peace of mind — Original Medicare + a Supplement gives you the gold standard.
Answered by Yasmine Lopez on June 6, 2025
Broker Licensed in UT, AL, AZ & 17 other states
Answered by Mary Brown on June 29, 2026
Broker Licensed in NJ, DE, FL & NC, OH, PA & TX
Who might consider Original Medicare:
1. Individuals who value flexibility and choice: With Original Medicare, you can choose any doctor, specialist, or hospital in the U.S. that accepts Medicare. This can be attractive for those who have preferred providers or want to avoid network restrictions.
2. Those who prefer a fee-for-service model: Original Medicare operates on a fee-for-service basis, where you pay a portion of the cost of covered services, and Medicare pays the rest. This can be a simple and straightforward approach for some individuals.
3. People who may have a Medigap policy: Many people with Original Medicare also have a Medigap policy (supplemental insurance) to help cover some of the out-of-pocket costs, like deductibles and coinsurance. This can make Original Medicare more financially manageable.
4. Those who may not need extensive additional coverage: Original Medicare provides a good foundation of healthcare coverage, and some individuals may not need or desire the added features and benefits offered by Medicare Advantage plans, such as additional coverage for vision, dental, or hearing.
5. Individuals who want to avoid network restrictions
Who might consider Medicare Advantage:
Individuals who prefer all-in-one coverage with low premiums and copays limited by an out-of-pocket maximum .
Those who live in areas with broad networks and don't mind getting referrals .
Individuals who can't afford a Medicare Supplement (Medigap) plan or who have a lower premium requirement .
Those who prioritize extra benefits like dental, vision, and hearing coverage .
Answered by Linda Davies on May 27, 2025
Agent Licensed in IL
• You can see any doctor or specialist nationwide who accepts Medicare — no networks.
• There are no referrals needed.
• Medigap plans can cover most or all of the 20% that Medicare doesn’t pay, which means predictable costs.
• There are no prior authorizations for most services.
However, that doesn’t mean Medicare Advantage is bad — some people prefer Advantage plans because they include extras like dental, vision, gym memberships, and low or $0 premiums.
The “better” option really depends on a person’s health needs, budget, and whether they prefer flexibility or extra benefits. I always help people compare both before deciding what fits their situation best.
Answered by Antonio Rodriguez on November 16, 2025
Broker Licensed in OR
UNLIKE MEDICARE ADVANTAGE PLANS, CAN REQUIRE YOU TO CHOOSE A GATE KEEPER PRIMARY CARE PHYSICIAN, THAT MANAGES YOUR CARE WITH REFERRALS TO SPECIALISTS REQUIRED, INCLUDING REQUIRED RESTRICTED DOCTOR AND HOSPITAL NETWORKS.
TRADITIONAL MEDICARE ALONG WITH A SUPPLEMENT ALLOWS YOU TO ACCESS ANY DOCTORS, HOSPITALS, REHAB CENTERS, ETC, ETC, ANYWHERE IN THE COUNTRY THAT ACCEPTS MEDICARE. NO NETWORKS, NO PRIMARY CARE DOCTORS REQUIRED, NO REFERRALS REQUIRED, A MUCH QUICKER AND EASIER AUTHORIZATION PROCESS FOR YOUR NECESSARY MEDICAL CARE.
IN SUMMARY, IT IS MY PROFESSIONAL OPINION THAT IF YOU CAN AFFORD A MEDICARE SUPPLEMENT YOU SHOULD ABSOLUTELY ENROLL IN ONE. REMEMBER, IF YOU EVER CHANGE YOUR MIND YOU CAN ALWAYS MOVE TO A MEDICARE ADVANTAGE PLAN IN THE NEXT ANNUAL ELECTION PERIOD WITHOUT ANY MEDICAL UNDERWRITING. IN MOST STATES YOU CANNOT MOVE TO A MEDICARE SUPPLEMENT WITHOUT MEDICAL UNDERWRITING AND MAY HAVE PRE EXISTING CONDITIONS EXCLUSIONS, UNLESS YOU FALL INTO A SPECIAL ENROLLMENT PERIOD ( SEP ) LIKE LOSING GROUP HEALTH INSURANCE , YOUR MEDICARE PLAN EXISTS THE MARKET ETC.
Answered by Jeffrey Sodikoff on October 16, 2025
Agent Licensed in FL
Part A covers hospital stays, nursing facility care, hospice care and home-based healthcare.
Part B covers doctor visits, outpatient care, durable medical equipment (e.g., wheelchairs, walkers) and many preventive services, like shots, vaccines and annual checkups.
With Original Medicare, once you pay your deductible, Medicare pays its share of the Medicare-approved amount, and then you pay what’s left (your coinsurance or deductible).
A Medicare Advantage plan is an alternative health insurance option that private insurance companies offer. Unlike Original Medicare, Medicare Advantage plans often bundle additional benefits into a single plan, making it easier to manage your healthcare needs. It includes everything in Original Medicare plus more. Some benefits Medicare Advantage plans may include:
• Prescription drug coverage
• Vision Services (e.g., eyewear, routine eye exams)
• Dental care
• Hearing Services (e.g., routine exams, hearing aids)
Many Medicare Advantage plans also offer wellness programs, fitness memberships, and expanded telehealth options, providing greater flexibility and value to members. These extra benefits can vary by plan and insurer, so it’s important to review the specific offerings when choosing a plan.
Answered by Monica Hughes on April 20, 2026
Agent Licensed in LA, AL, AR & 16 other states
Answered by Sam Silva on June 24, 2025
Broker Licensed in FL, GA, NJ & 7 other states
The question on the floor is whether or not Medicare is better than an Advantage plan. I want to make sure that we don't use words like "better than" or "the best." What's suitable, what's appropriate, what's supportive of your own healthcare is really what we have to focus on.
Here's what happens with original Medicare A and B, that hospital and medical, the red, white and blue card. It is actually accepted in every state. There's no limitations to where you can go because everybody takes it. However, it's 80% of your healthcare covered by Medicare if it's medically necessary.
Okay, so then the other part of it is that 20% is left to be spent by you. That's your part of that medical expense. In addition to that, there are deductibles and copayments. So there's a deductible for Part A and there's a deductible for Part B. And you have a premium for Part B. So there's some costs associated with having Medicare.
Additionally, if you get sick and you have an incident, for the first 60 days of that incident, come home, come back from the hospital, everything's fine. But you have an additional or a new incident 60 days later, you've got to pay the deductible again for our original Medicare.
Okay, so now at $1,680 for a one-time shot and 20% of the expense, what if it was a broken hip and the hip is $100,000? Now you have a $20,000 bill plus a $1,600 deductible. Just putting it out there. So unless you have cash money to pay for Medicare A and B and all the associated costs, you're on the hook for finances.
Now, there are things like an indemnity plan, which will indemnify you or reimburse you the money you spent, but not the entirety. Or the Advantage plans. Would you pay something? You don't have to pay anything monthly, but you have a deductible that is significantly less than that 20%, because you have an insurance company like a Humana and Aetna, United, or somebody bigger, a carrier that's going to offset some of the price. And for being their customer, they're going to give you their portion, and they're going to give you health, doctor, prescription drugs, and a few extra things like dental, vision, hearing, maybe fitness, even a meal, and even transportation. So they have advantages that are all booked together.
Whereas if you're just on original Medicare, you would be paying for everything, and you're required to have a Part D prescription drug plan, and you're required, well, if you want to have vision, dental, and hearing, an additional 30 or $40 a month for just that service as well, and then you still have to figure out transportation.
Answered by Tamekia Mckinnie on July 11, 2026
Agent Licensed in FL
Answered by David Wiley on April 6, 2026
Broker Licensed in GA & NC
Answered by Michael Wehner on March 16, 2026
Agent Licensed in IN, KY, NC, OH, PA & SC
We actually have a cost by cost comparison of this question in all of our slides that we use for seminars. In extremely rare cases is Original Medicare "better" than Advantage. With Original Medicare you owe 20% with no cap throughout the year. IE. surgery on Jan 1 costs 100k and complications from said surgery on April 3 cost 50k, you're on the hook for 20% of those two bills, without a cap in sight for the duration of the year.
What people mean when they say "better" , things are approved quicker or not as much headaches with Original Medicare only. Again, very rare cases (if ever) does only Original Medicare make sense.
Answered by Ryan George on June 1, 2026
Broker Licensed in PA, AK, AL & 49 other states
Answered by Jonathan Paddon on November 3, 2025
Agent Licensed in TN, AL, FL, GA, IL & MS
However, MA plans cap out-of-pocket costs and bundle extras like dental. Original Medicare only covers 80% of health care costs and there is no cap on out of pocket expenses.
Answered by Douglas Carney on May 10, 2025
Broker Licensed in FL, GA, NC, OK & TX
Answered by Alexander Lehn on April 28, 2025
Agent Licensed in NV, CA, FL & TX
Hi, thanks for watching. My name is Steve and I'm the husband half of the husband and wife Medicare team here in Arizona. Sue is off today. So the question we have is someone's asking why is regular Medicare better than an Advantage plan?
I'm gonna start off by saying what's better is what you think is better. The reason I'm saying that is that for some people, original Medicare with a supplement, otherwise known as a Medigap plan with a drug plan, might be better than a Medicare Advantage plan, which I call a bundled product.
Okay, if you travel a lot, if you want to access benefits outside of your home state, and you want to go to any doctor that accepts Medicare, they call it Medicare assignment, which means that they've agreed to the Medicare fees that Medicare is willing to pay. If that's what you want, then regular Medicare, original Medicare, is what they call it, would be a better fit for you.
Medicare Advantage, on the other hand, is a plan where it's a copay, typically a copay-based pay-as-you-go model. The original Medicare with a drug plan is a pay upfront model, which means you pay a premium every month for the supplement or Medigap, whatever you want to call it. You pay upfront for the Medigap plan and the drug plan, whether you use it or not.
With an Advantage plan, it's a pay-as-you-go model, meaning there's typically, not always, but it's typically a zero premium every month. And when you go get services, you pay co-pays depending on the service. It could be a zero copay or whatever. There's all that's all over the map what the copays are.
So to really answer the question, what's better is what you think is better and what works for you. So if anybody says, "Oh, this is better" or "that's better," that might be better for them. But every situation is different.
Answered by Steve and Sue Brauer on December 10, 2025
Broker Licensed in AZ & CA
Original "regular" Medicare by itself with no supplement is not recommended. There could be unlimited medical bills to you of 20%, after medicare pays their 80% cost share.
Some Medicare Advantage HMO or PPO plans cost $0 per month, yet you will have out of pocket costs and copays for some Doctor visits, tests. treatments and hospitizaions. It is a "pay as you go" type of plan that has a Network of providers. You may also need to get a referral to see a specialist
The Medigap plan doesnt have a network, and you do not need a referral to see a Specialist. As long as the Provider accepts Medicare then then Medigap Supplement will pay after Medicare pays their share of the bill.
Medigap is unaffordable for some people. In this case, a Medicare Advantage Plan may be the next best thing.
Answered by Shauneen Sullivan on October 27, 2025
Agent Licensed in FL, AZ, GA & 9 other states
Medicare Advantage has to cover the exact same things as original Medicare. So they myth that they cover less is not accurate. It is a law they have to cover the same things but they also cover more. An example is many have Dental , Eye , hearing and over the counter coverage that original Medicare does not. They come in forms of PPO's so you can use them anywhere that accepts Medicare and you can use them out of state and country. The network is typically large. The Doctors now have to bill the carrier you picked and not Medicare. It does NOT replace Medicare. Nothing can replace your Medicare.
Some States vary on this. Some states and counties just don't have access to Medicare advantage. In that instance, you will need a medigap.
The Medicare Advantage is also Guarantee Issue : Which means everyone is accepted regardless of medical back ground. Supplemental or Original Medicare you have to be medically approved or healthy to be accepted unless you are in your original enrollment period.
Answered by Tasha Riggs on April 12, 2025
Broker Licensed in CO, AZ, HI & 10 other states
Answered by Frank Buonomo on March 31, 2025
Agent Licensed in NV, CA, ID & IL, NM, OR & TX
I can safely say neither system is perfect, but they both work and are effective.
Personally as an agent and Medicare user, I've been on an Advantage plan since age 65 (now 73) and have had open heart surgery, gall bladder and cataracts removed. All were done with exceptional care. I always thought I'd only take the Supplement at age 65 but the Advantage plans kept getting richer and richer in benefits, so I went that direction. I present both options to my clients and let them decide.
Answered by Mitchell Jerome on June 10, 2026
Broker Licensed in TX
Answered by Diane Andree on April 10, 2025
Agent Licensed in NY
Answered by Mark Boone on April 1, 2026
Agent Licensed in MN, FL, MI & NC, OH, SC & VA
-less out of pocket if you buy a medigap policy like Plan N or G to go with it.
-Go anywhere in the country medicare is accepted
-more lenient when it comes to authorizations and pre approvals.
Answered by Tyler Haskell on August 4, 2025
Broker Licensed in UT
Why some people prefer it:
See any doctor nationwide (no networks)
No referrals needed
More predictable coverage with a supplement
Trade-off: higher monthly costs vs. Medicare Advantage’s lower premiums but more restrictions.
Answered by Priscilla Ramos on April 14, 2026
Agent Licensed in OH, AZ, FL & 6 other states
However, you may be interested in learning that Medigap Plans help cover out-of-pocket costs associated with original Medicare, such as copayments, coinsurance, and deductibles. Specific benefits vary by plan, but most cover costs like hospital fees and some emergency medical services when traveling abroad.
Answered by Judith Carney on September 8, 2025
Broker Licensed in FL, AZ, KS, MO, NC & OK
By contrast, Medicare Advantage plans are often less expensive and may include additional benefits, but they typically require the use of a provider network and may involve deductibles, co-pays, or other out-of-pocket costs for services.
Answered by Steven Kirsch on March 16, 2026
Agent Licensed in MI
Answered by David Williams on August 13, 2025
Broker Licensed in OH
It's just a personal preference and a budgetary consideration.
Answered by Mark Murphy on February 24, 2026
Agent Licensed in NJ, AL, CO & 9 other states
Answered by Angelina Watkins on November 21, 2025
Agent Licensed in OH, FL, GA & 5 other states
Yes, MA makes it sound nice with glasses, teeth cleaning, maybe even a grocery card, but you then give them control of your health completely. So please consider that in your thinking.
Good luck!
Answered by Norman Smith on April 19, 2025
Agent Licensed in FL, AL, NJ & PA
Answered by Kandance Magee on February 16, 2026
Broker Licensed in LA, AL, FL, GA, MS & TX
Answered by John Messler on February 23, 2026
Agent Licensed in NH, ME, NC, OH, PA & TX
Answered by Todd Bostic on December 29, 2025
Broker Licensed in TX, AL, AZ & 12 other states
Some individuals prefer to enroll into a Medicare Advantage plan for the extra benefits and the maximum out of pocket cost.
With the selection of either plan it is important to calculate the cost you will have over the period of time you will be in retirement which can last twenty to thirty years. As we get older health cost more.
Answered by Jerry Wilson on June 6, 2025
Broker Licensed in WI, IL, MS, NC, TN & TX
Answered by Lauryn Ivey on June 3, 2025
Broker Licensed in AL
Answered by Vachik Chakhbazian on August 30, 2025
Agent Licensed in CA, AL, AR & 22 other states
Answered by Steven Guiness, CSA on June 29, 2026
Broker Licensed in GA & FL
Answered by Steven Bleicher on March 27, 2025
Broker Licensed in AZ
Answered by Leslie Kaz on October 27, 2025
Agent Licensed in CA, AL, AZ & 7 other states
Medicare doesn't operate on a network like Advantage plans do. Medicare Advantage plans have HMO, PPO, & PFFS networks.
Answered by Diana Garner on May 13, 2025
Broker Licensed in KY, FL, IN, OH & TN
Medicare Advantage plans can be more affordable and offer extra benefits, but may have restrictions on provider choice and require prior authorization.
Answered by Fred Manas on April 14, 2025
Agent Licensed in NY, CT, DC & 7 other states
Answered by Meghan Blankenship on November 13, 2025
Broker Licensed in FL, MD & OH
Answered by Pamela Masters on October 19, 2025
Broker Licensed in NC
Answered by James Stang on June 24, 2025
Agent Licensed in OH
Answered by Ana V. Magalhaes on November 3, 2025
Broker Licensed in MA, AZ, CA & 7 other states
But it only covers 80% of your charges
And it does not offer prescription drug you would have to buy this separately
Answered by Gisele Salas on May 11, 2026
Agent Licensed in FL
Answered by Shelly Hefley on May 22, 2025
Broker Licensed in IN, AL, IL, KY & TN
Answered by Kristen Skinner on October 24, 2025
Broker Licensed in OK
Medicare Advantage limits those cost but has a network one needs to stay within to get the most out of their benefits
Original Medicare and a Medicare Supplement plan is a good way to go if it's affordable to the beneficiary.
Answered by Marcie Barnes on November 14, 2025
Agent Licensed in TX, AK, AL & 48 other states
Answered by Joseph Peck on February 16, 2026
Agent Licensed in MI, AL, CO, KS & TN
Answered by Donald Baker on April 20, 2026
Agent Licensed in MN
Answered by Teresa Wagner on June 22, 2026
Broker Licensed in OH, IN & MI
You can't have a Medicare Advantage Plan without Regular Medicare. That being said, it is subjective in terms of one being better because each individual situation is different. Also, the Medicare Advantage Plan helps with the non-capped 20 percent cost that Regular Medicare has.
Answered by Sandy Johnson on September 22, 2025
Broker Licensed in LA, AL, AR & 11 other states
Answered by Robin Mulcahy on January 21, 2026
Agent Licensed in WI
Answered by William Lawler on April 7, 2025
Broker Licensed in MO, FL, IA & 12 other states
Answered by Suzanne Lamperti on June 5, 2025
Broker Licensed in MD
Answered by Tameeka Johnson on November 13, 2025
Broker Licensed in VA, FL, NC & NJ, NY, SC & TX
Answered by Mike Alexander on November 3, 2025
Broker Licensed in TX, AL, AR & 16 other states
Answered by Mark Cunningham on April 7, 2025
Agent Licensed in CO, FL, GA & NE, VA, WI & WY
Answered by Angela Olson on May 2, 2025
Broker Licensed in UT, AZ, CO & 5 other states
Answered by Gary Church on June 9, 2025
Broker Licensed in CA, AZ, NV & TX
This also has a lot to do with whether you need freedom to go wherever you need to go Nationwide wherever original Medicare is accepted or your insurance is or gives you the freedom to go wherever you need to go and your Health Issues there’s a lot of concerns here with this question, so make sure you work with the agent that does a deep dive Discovery on your background, your history, etc.
Answered by Hope Suhr on May 21, 2025
Broker Licensed in CA, AZ, MO & OR, SC, TN & TX
Answered by Josh Vojtush on April 21, 2025
Broker Licensed in OH, FL, IL & MI, NC, SC & VA
https://www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/your-coverage-options/compare-original-medicare-medicare-advantage
Answered by Thomas Magnus, RHU on June 23, 2025
Broker Licensed in CA, AZ, NV, OR & WA
Answered by Kathy Adams on April 25, 2025
Agent Licensed in NV & ND
Answered by Clark Barkley on January 26, 2026
Agent Licensed in IL
Answered by Don Golding on October 27, 2025
Broker Licensed in TX, AL, AR & 5 other states
Answered by Susan Rittenberry on August 19, 2025
Broker Licensed in AL & NV
Answered by Sheila Simpson on May 25, 2026
Agent Licensed in GA, AL, AZ & 5 other states
Answered by Dana Dane on April 3, 2025
Agent Licensed in OR, AZ, CA & 6 other states
Answered by Erica Clout on May 21, 2025
Broker Licensed in NY, CT, FL, GA, NJ & PA
Answered by Tony Capraro III on April 15, 2025
Agent Licensed in NH & ME
Clear answer, without knowing you, and what your needs, and concerns are. Each person is unique and I try to identify your exact need.
Answered by Pat Papson on September 1, 2025
Agent Licensed in NM
Tags: Medicare Advantage Medicare Part A Medicare Part B
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