Medicare vs. Medicare Advantage: What You Need to Know Before You Choose (or Renew)
Let’s be honest—Medicare is confusing. Traditional Medicare, Medicare Advantage, Part B, Part D, supplemental plans... it’s a lot to sort through. But understanding your coverage—or your loved one’s—is more than just paperwork. It can make a huge difference in the quality of care you receive and what you pay out-of-pocket.
Here’s what you need to know, in plain English.
First, What Kind of Medicare Do You Have?
If you (or your loved one) is 65 or older and the primary insurance card you use is the red, white, and blue Medicare card, then you have Traditional Medicare.
If your card has the name of an insurance company—like UnitedHealthcare, Humana, Cigna, or Aetna—then you're on a Medicare Advantage plan. That means you’ve given up Traditional Medicare and a private company is managing your benefits.
How Do the Two Options Compare?
📌 Traditional Medicare
You pay a monthly premium for Part B (medical coverage) and Part D (prescription drugs).
You likely also pay for a Medicare supplement (Medigap) to cover what Medicare doesn’t.
No annual out-of-pocket limit—your costs can add up fast.
Doesn’t cover dental, vision, or hearing.
Accepted nearly everywhere Medicare is accepted—great for those who travel or want choice.
📌 Medicare Advantage
May have low or no monthly premium.
Includes an out-of-pocket max (a cap on how much you’ll spend in a year).
Usually includes drug coverage (Part D).
Often includes extra perks like dental, vision, hearing, gym memberships, grocery cards, and over-the-counter allowances.
So Why Is Everyone Talking About Medicare Advantage?
Let’s be honest—those perks are appealing. And for many people, it’s the only option they can afford. But here's the catch:
Once you leave Traditional Medicare, it’s hard—and sometimes impossible—to go back and get a Medigap plan.
Advantage plans can change every year: drug coverage, supplemental benefits, provider networks, and more.
What’s covered this year might not be covered next year.
What’s Happening Right Now in the Market
Major changes are underway in the Medicare Advantage world:
UnitedHealthcare is pulling out of plans serving over 600,000 members.
Humana is exiting certain geographic markets, impacting half a million people.
CVS Health is focusing more on profits over membership growth.
Cigna has exited the Medicare Advantage market entirely.
In other words: don’t assume your current plan will be available—or worth keeping—next year.
💡 If You Have a Medicare Advantage Plan...
Please, review your plan every fall during open enrollment. Your current coverage could change dramatically:
Doctors may no longer be in-network
Drug formularies can shift
Those vision, hearing, and dental benefits? Gone
The “extra perks”? Often the first thing to disappear
📣 If You're Turning 65 Soon...
Don’t just sign up for what sounds cheapest or most convenient. Do your research:
Understand what you’re getting
Know what you’re giving up
Realize that what’s offered this year may not be offered next year
We're Here to Help You Make Sense of It
At Haven Healthcare Advocates, we don’t sell insurance—but we do help clients understand their options, weigh risks, and make informed decisions based on real-life needs and long-term impact.
At Haven Healthcare Advocates we provide expert, trusted, nurse-led healthcare advocacy and care management, ensuring your loved ones receive compassionate, high-quality care. We make sure you have and understand your healthcare and then we make sure nothing falls between the cracks. Through our expert guidance we provide peace of mind and restore family harmony. Healthcare is complicated, we make it easy..
To learn more about Haven Healthcare Advocates please visit our website at www.havenhca.com or click here to schedule a consultation.