When you first become eligible, you must enroll in Original Medicare, and then it is up to you to choose whether you will need additional coverage from a Medicare Advantage plan.
We have created this page as a guide to help you understand the differences between Original Medicare and Medicare Advantage, as well as walk you through whether a Medicare Advantage plan is right for you.
While Medicare Advantage plans offer the same benefits as Original Medicare and are also regulated by the government, there are many differences between the two.
For one, Medicare Advantage plans are run by private insurance companies and can offer additional benefits that Original Medicare does not cover, like prescription drug plans, a maximum cap on out-of-pocket expenses, and additional coverage options like attendant care, fitness benefits and hearing aids.
Medicare Advantage plans also traditionally offer lower copays and require that you use a doctor, hospital or health care provider within the plan's network. Keep in mind that while coverage options differ for each Medicare Advantage plan, costs and limits also vary with private insurance company plans.
Like most Medicare Advantage plans, the Memorial Hermann Advantage HMO plan provides you with additional benefits and, in some cases, also lower coverage costs. Additional benefits include, but are not limited to, $0 monthly premiums, prescription drug coverage, dental benefits, hearing aid and annual vision examination coverage, and a maximum cap on out-of-pocket costs.
Some plans charge an additional premium for their Medicare Advantage plan, meaning that you pay both your Part B premium and your private insurance plan’s premium each month. With the Memorial Hermann Advantage HMO plan, there is no monthly plan premium, so you only have to pay your required Part B premium every month. For Part D Prescription Drug Coverage, there is an annual deductible of $300 for prescription drugs applicable to tiers 4 and 5 of our formulary.
The Memorial Hermann Advantage HMO health plan is backed by the Memorial Hermann Health System — a trusted name in Houston health care for more than 100 years. With the Memorial Hermann Advantage HMO plan, you get a high level of care near where you live or work, because Memorial Hermann has numerous facilities throughout the city, including hospitals, imaging centers, specialty institutes and more.
Enjoy the freedom of seeing any network specialists you like, without needing a referral from your primary care provider or family doctor.
Wherever your travels take you, you’re covered for urgent or emergent care.
Now that you know the major differences between Original Medicare and Medicare Advantage, you can take the next step and learn more about the Memorial Hermann Advantage HMO plan.
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