Medicare Advantage vs. Original Medicare: What's the Difference

October 2026

If you're approaching Medicare enrollment, you may be wondering about the difference between Original Medicare and Medicare Advantage. Understanding the basics can help you make informed decisions and know where to find expert guidance.

Before enrolling, check with your insurance provider to verify that Providence is in network (contracted) with the plan you are selecting. Taking a few minutes can help you avoid surprises and keep continuity of care with the Providence doctors, clinics and hospitals you know and trust. To see our accepted Medicare plans, visit providence.org/keepmydoctor.

What is Medicare?

Medicare is a health insurance program run by the Centers for Medicare and Medicaid Services (CMS). It includes several parts that help cover different health care services:

• Part A (Hospital Insurance): Covers inpatient hospital stays, skilled nursing facility care, hospice care and some home health care.
• Part B (Medical Insurance): Covers certain doctors' services, mental health, lab tests, X-rays, medical supplies and preventive services.
• Part C (Medicare Advantage): Plans are offered by private insurance companies that provide dental and vision coverage.
• Part D (Prescription Drug Coverage): Helps cover prescription medications and can be added to Original Medicare. Some Medicare Advantage plans also include prescription drug coverage.

Comparing Original Medicare and Medicare Advantage

Original Medicare (Parts A and B) allows you to see any provider that accepts Medicare. However, it does not cover all health care costs or services. Adding a supplemental plan may help cover additional costs. You can also add a Part D prescription drug plan.

Medicare Advantage (Part C) plans provide Part A (hospital insurance) and Part B (medical insurance) coverage, and most include Part D (prescription drug coverage). Plans may offer extra benefits, such as dental, vision and hearing coverage. You may be required to use a contracted provider network in your area. When choosing a plan, make sure your doctor is considered in-network (contracted).

As you compare your options, consider:

• Can I continue seeing my preferred doctors?
• Are my medications covered?
• How much will I pay for care throughout the year?
• Does the plan meet my health and budget needs?

Get local help

• See the Medicare plans that Providence accepts at providence.org/keepmydoctor
• <_o3a_p>Call Medicare at 1-800-MEDICARE (1-800-633-4227) or visit their website at Medicare.gov.
• <_o3a_p>Search for local help near you at OregonHealthcare.gov.<_o3a_p>
• Providence partners with the independent Medicare advisors at DDI Benefits, Inc.
  • <_o3a_p>Join a live Medicare 101 webinar. Register for free at: Medicare 101 Seminars | DDI Benefits
  • Watch Medicare 101 refresher video.
  • Contact DDI Benefits at 503-206-4080 or 844-806-2500 (TTY: 711), email: [email protected], website: Medicare | DDI Benefits
• Oregon Senior Health Insurance Benefits Assistance (SHIBA) has trained, free counselors to assist with Medicare.
  • <_o3a_p>Attend an in-person or virtual presentation. Register at: Medicare Help : Events and Presentations : Get Help : State of Oregon
  • <_o3a_p>Call 800-722-4134 (TTY 711), email [email protected], website: Medicare Help : Medicare Help : State of Oregon <_o3a_p>