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Choosing between Medicare vs Medicare Advantage is often confusing.  While both cover medical expenses in retirement, the coverage and costs differ greatly.    In this article, we’ll explore Medicare vs Medicare Advantage to help you make an informed decision for your healthcare coverage in retirement.  But before we dig into Medicare vs Medicare Advantage, let’s review each one.



Medicare is a federal program aimed at covering healthcare costs for anyone over 65 and some disabled people.   Medicare has 4 main parts, A, B, C, and D.  Medicare Part A covers hospital and some long-term care.  Medicare Part B is medical insurance.  It covers doctor and outpatient care, durable medical equipment, and preventive care, like wellness checks.  Medicare Part C is Medicare Advantage.  We’ll review Part C below.  Finally, Medicare Part D is bought separately to cover prescription drugs.


Medicare Advantage

Medicare Advantage plans are managed by private health insurance companies approved by Medicare.  And Medicare pays the insurance company for the care.  Medicare Advantage plans are an alternative to Medicare.  But the covered services are often different.  Let’s explore Medicare vs Medicare Advantage plans deeper.


           Comparison Chart of Medicare vs                             Medicare Advantage


Medicare Advantage

Hospital & Medical Coverage

Hospital and medical plans are separate 

Combines hospital and medical into one insurance plan 

Doctors and Networks 

Any that accept Medicare 

Restricted to plan; you may need referrals for specialist 


Open to U.S. citizens and Legal Residents 65 and older and some disabled persons 

Open to U.S. citizens and Legal Residents 65 and older and some disabled persons 


3 months before, the month of, and 3 months after you turn 65 

When you become eligible for Medicare; special enrollment period (SEP); open enrollment period (OEP)-1/1/24 to 3/31/24; and annual enrollment period (AEP)-10/15 to 12/7.   

*Switch Medicare vs Medicare Advantage and back 

Annual enrollment period (10/15 to 12/7)-coverage starts 1/1 of following year 

Annual enrollment period (10/15 to 12/7)-coverage starts 1/1 of following year 

*Change Medicare Advantage Plans 

Part A is typically free; premium may apply if worked less than 30 quarters.  Part B monthly premium is $164.90 in 2023 

Vary by plan.  Some have low to no monthly premium 

Out-of-Pocket Costs 


Capped per plan 


Part A: $400 for days 61 to 90 

Typically, 20% as approved by Medicare 


Part B deductible $226 in 2023    Part A deductible $1600 in 2023 per inpatient episode 

Varies by plan 

Extra Benefits 


May include dental, vision, hearing, and other benefits 

Chronic Conditions and Special Needs Plans 


Varies by plan 

*, January 2023 (Retrieved October 25, 2023).

Patient Satisfaction

Both Medicare and Medicare Advantage plans have similar levels of patient satisfaction with care, wait times, and finding a doctor (September 20, 2022).  But one concern where Medicare vs Medicare Advantage plans differ is where care is received.  A 2022 review of 62 studies, showed Medicare beneficiaries received care in the Highest-Rated hospitals compared to Medicare Advantage members.  And while Medicare Advantage plans manage prevention well, they may be problematic for those with complicated medical problems.


In conclusion, the decision between Medicare vs Medicare Advantage depends on your individual needs and preferences.  Consider your healthcare needs, budget, and preferred doctors and hospitals.  Medicare Advantage plans may have lower monthly premiums but could result in higher out-of-pocket costs in some cases.  And while Medicare has more predictable costs, you may need to buy additional coverage for prescription drugs and other services.  Consider speaking with a Financial Advisor who focuses on retirement planning for nurses to help you decide which coverage is best for you.

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These concepts were derived under current laws and regulations. Changes in the law or regulations may affect the information provided.




Categories: Healthcare

Georgene Collins

Georgene Collins, RICP®, RN, PhD, MBA is a registered nurse turned Financial Advisor at Airey Financial Group. Georgene helps other nurses take control of their finances and prepare for retirement. Georgene began her career with Airey Financial Group in 2017 after retiring from 30 years in healthcare. Georgene holds the Retirement Income Certified Professional (RICP®) designation from The American College of Financial Services. She holds health and life insurance licenses and a long-term care certificate in Indiana, Illinois, and Wisconsin. Georgene is a Registered Representative and Investment Advisor Representative and has earned the FINRA Series 63 and 65 registrations.