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Medicare & Medicare Advantage: What's the Difference?

Medicare was created over 50 years ago to assist Americans with the oftentimes exorbitant medical expenses they face as they age.

But, in the intervening decades, as life expectancies have risen and medical practices have improved, so too have the range of patient needs — and medical expenses — that everyday Americans encounter.

Nowadays, a government-sponsored Medicare plan alone — often referred to as original Medicare — will not address all the expenses that you’re likely to deal with as you age. That’s where enhancements from insurance providers like BlueCross BlueShield of South Carolina come in.

We offer both Medicare Advantage and Prescription Drug Plans. Here's a brief overview of how our plans compare to original Medicare:

Compare Your Medicare Options

  Government Plan Private Plan
  Parts A & B
(Original Medicare)		 Part C
(Medicare Advantage)		 Part D
(Prescription Drug Coverage)
Hospital coverage yes yes  
Visits to the doctor yes yes  
Prescription Drugs   yes yes
Dental Coverage   yes  
Hearing and vision coverage   yes  
Preventative care yes yes  
Fitness membership benefits   yes  
Out-of-pocket maximum   yes  
    Medicare Advantage Plans Prescription Drug Plans

Medicare: Parts A – D

Original Medicare (Parts A & B) 

If you live with an eligible disability, or you’re 65 years of age or older, then you are eligible for support through Medicare, which is comprised of two different coverage areas, referred to as “parts.”

Parts included in original Medicare plans cover the following:

  • Part A – Covers inpatient care in a hospital context, home health care, hospice care, skilled nursing facility care, nursing home care, and more
  • Part B – Covers preventive care through your doctor, as well as other medically necessary services — this could include but is not limited to: ambulance services, mental health support, and more

While there isn’t typically a monthly premium for Part A coverage, Part B coverage does require one. (This Part B premium is usually deducted from your monthly Social Security check.)

Additionally, both Parts A and B require patients to pay deductibles and coinsurance.

Medicare Advantage & Medicare Drug Plans (Parts C & D)

Parts C and D of Medicare are provided through private organizations like BlueCross.

These organizations, which are sometimes insurers, contract with Medicare to offer government-approved “enhancements” that replace the basic offerings available through Medicare Parts A and B.

Accordingly, the premiums, deductibles and other expenses associated with Parts C and D vary depending on what insurer you choose to do business with, and which of their plans you choose.

Here’s a brief rundown of what Parts C and D entail:

  • Part C — Medicare Advantage plans offer a range of enhancements to the typical benefits associated with Medicare Parts A and B. What’s more, they can also include additional services that are not covered by Parts A and B, including prescription drug coverage which is otherwise available only through Medicare Part D. 
  • Part D — Focusing exclusively on prescription drug coverage, Part D can be purchased as a standalone plan, or be folded into a Part C Medicare Advantage plan

Ready to explore Medicare Advantage plans available through BlueCross? Access more information about our offerings through this link.

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Disclaimer

Last Updated: November 12, 2024

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BlueCross BlueShield of South Carolina is a Medicare Advantage PPO plan with a Medicare contract. BlueCross Rx Value is a stand-alone prescription drug plan with a Medicare contract. Enrollment in BlueCross Total, BlueCross Total Value, BlueCross Blue Basic, or BlueCross Rx Value depends on contract renewal. 

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments and restrictions may apply. Benefits, premiums and/or copayments/coinsurance may change on January 1 of each year. 

Out-of-network/non-contracted providers are under no obligation to treat BlueCross BlueShield of South Carolina Medicare members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call Customer Service or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. 

BlueCross BlueShield of South Carolina does not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation or health status in our health plans, when we enroll members or provide benefits. Free language interpretation services are available for those who cannot read or speak English.