Medicare Options Compared

Medicare Comparison Table

Making the switch to Medicare can be overwhelming. If you are reaching this important milestone in life, the following Medicare options chart will help you get started on your way to a smooth transition of healthcare. 

Original Medicare Medicare Advantage Medigap
Type of Coverage Provided and managed by Federal Government Provided and managed by private carriers contracted with Medicare Sold by private carriers approved by Medicare
Providers / Referrals Any provider who accepts Medicare Nationwide, no referral needed Predetermined Network and you may need a referral to see a specialist Any provider who accepts Medicare Nationwide, no referral needed
Coverage Parts A (Hospital) & B (Medical) Part C (combines A & B into one plan) (replaces your Original Medicare) Pays 50% to 80%, and in many instances 100% of the costs not covered by Original Medicare*
Deductible For Part A - $1,676** Varies per carrier, from ZERO to having a separate deductibles for medical care and prescription drugs*** N/A
For Part B - $257
Copays Beneficiary pays 20% of approved services (after deductible) National average $20 per doctor visit, $75 for ER or Urgent Care, copays vary for prescriptions based on drug tiers, generics range from $3-$5 N/A
Out-of-Pocket Maximum None Average can range from ZERO to $9,350**** Plans K - $7,220
Plan L - $3,610
Prescription Drugs, Dental, Vision, Hearing Not part of Original Medicare Parts A & B***** Some plans include these ancillary benefits Not covered under Medigap
Average Premium Most people Part A is free, Part B rate is $185.00 in 2025****** Each company sets its own rates Average of $25 + Part B standard rate Rates vary based on age and where you live, national mo. average is $185, but can be as low as $70 per month and as high as $500 in 2025*******
Medical Underwriting None You can't be turned down or charged more because of a health condition during initial open enrollment Applies only if you miss your initial open enrollment period and do not qualify for a special enrollment********
Original Medicare
Type of Coverage Provided and managed by Federal Government
Providers/ Referrals Any provider who accepts Medicare Nationwide, no referral needed
Coverage Parts A (Hospital) & B (Medical)
Deductible Part A - $1,676, Part B - $257
Copays Beneficiary pays 20% of approved services (after deductible)
Out-of-Pocket Maximum None
Prescription Drugs, Dental, Vision, Hearing Not part of Original Medicare Parts A & B
Average Premium Most people Part A is free, Part B rate is $185.00 in 2025
Medical Underwriting None
Medicare Advantage
Type of Coverage Provided and managed by private carriers contracted with Medicare
Providers/ Referrals Predetermined Network and you may need a referral to see a specialist
Coverage Part C (combines A & B into one plan) (replaces your Original Medicare)
Deductible Varies per carrier, from ZERO to separate deductibles for medical and prescription drugs
Copays National average $20 per doctor visit, $75 for ER or Urgent Care, varies by drug tier
Out-of-Pocket Maximum Average can range from ZERO to $9,350
Prescription Drugs, Dental, Vision, Hearing Some plans include these ancillary benefits
Average Premium Each company sets its own rates, average of $25 + Part B standard rate
Medical Underwriting Cannot be turned down or charged more due to a health condition during open enrollment
Medigap
Type of Coverage Sold by private carriers approved by Medicare
Providers/ Referrals Any provider who accepts Medicare Nationwide, no referral needed
Coverage Pays 50%-80%, and sometimes 100% of costs not covered by Original Medicare
Deductible N/A
Copays N/A
Out-of-Pocket Maximum Plans K - $7,220, Plan L - $3,610
Prescription Drugs, Dental, Vision, Hearing Not covered under Medigap
Average Premium Rates vary based on age and location, national avg. $185, can range from $70 to $500
Medical Underwriting Applies only if you miss your initial open enrollment and do not qualify for special enrollment

Notes


*Also covers skilled nursing facility and foreign travel. Medigap cannot be purchased if you have Medicare Advantage. The majority of Medigap plans do not cover the Part B deductible of your Original Medicare, and per Medicare, Plans that do cover the Part B deductible (F & C) cannot be offered to new beneficiaries enrolling in Medicare.

** For Medicare Part A there is no coinsurance until you have reached your 60th day of hospitalization in each benefit period. Then you pay $419 per day until the 90th day. If you are in the hospital longer than 90 days, you can pay the full bill yourself or use your lifetime reserve days at $838 per day (up to 60 days in a lifetime).

*** Medicare allows up to $590 maximum deductible in 2025 for Prescription Drug coverage, however, half of all Medicare plans have a much smaller or ZERO deductibles for Part D. Keep in mind, these plans may have higher premiums as a trade-off.

****Unlike Original Medicare that has no maximum out-of-pocket (MOOP), the good thing about Medicare Advantage is you pay nothing for covered healthcare once you hit your annual MOOP. While some MA plans (about 20%) set the MOOP at the maximum allowed by Medicare at $9,350, many other carriers choose to have a much lower or no MOOP.

*****You will need to enroll in a separate Medicare Part D drug plan. To see Part D premiums, copays, deductibles for 2025, please visit our Medicare Premiums page.

******To see Medicare premiums, copays, deductibles or 2025, please visit our Medicare premiums page.

*******To see Medigap plans, premiums, copays and deductibles, please visit our Medicare Supplement page.

********You are entitled to the lowest possible rate if you act during the initial open enrollment period. After that, unless you qualify for special enrollment, you will have to go through underwriting and may not get the best rate.


Disclaimers:
While Medicare premiums are the same in many states across the US, rates can and do vary in other states. The content above represents national averages, and some parts were retrieved from Medicare.gov.


Charline Covington-Plerqui and PTI Consulting Services are not part of the Federal Government Medicare System. The content in this post has not been reviewed or approved by Medicare.

Medicare Supplement Plans

Medicare Supplement insurance will lower your medical costs by paying all or a portion of your out-of-pocket costs that your Original Medicare doesn’t cover. Premiums vary depending on the plan you choose, the carrier who offers the plan, the area in which you live and your age. Most often you can see any doctor you wish. Click below to see plans and coverage details. To purchase the right plan for your specific needs and budget, please contact our Licensed Medicare Agent.

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