Original Medicare
Original Medicare by itself is just a starting point; it covers doctor visits and hospital stays. You usually pay a monthly Part B premium and must meet yearly deductibles. Original Medicare will then cover 80% of the approved amount and you’re responsible for the remaining 20% of the costs. Part D (prescription drug coverage) is not included and you would have to purchase a stand-alone prescription drug plan to have coverage and avoid a Late Enrollment Penalty (LEP).
There is no limit to your out-of-pocket costs each year.
Medicare Advantage
Medicare Advantage plans include Part A and Part B benefits and most include coverage for prescription drugs (Part D). Most plans include coverage for dental, vision and hearing-benefits not offered by Original Medicare Parts A and B. Most Medicare Advantage plans have no additional premium and a cap to your yearly out-of-pocket expenses.
If you reach the maximum out-of-pocket amount, you pay nothing for your covered in-network services for the rest of the calendar year.
