Do You Need Medicare Part B with a Medicare Advantage Plan?

March 01, 2025•3 min read

Understanding Medicare and Its Different Parts

Medicare can be a bit complex as it offers various parts, each serving a unique purpose in your health coverage. Let's break it down:

Original Medicare: This includes Part A (hospital insurance) and Part B (medical insurance). Original Medicare covers doctor visits, hospital stays, and some preventive services.
Medicare Part B: Focuses on outpatient care, covering services like doctor's visits, preventive services, and some home health care. You'll need to pay a Part B premium.
Medicare Advantage Plan (Part C): These plans are offered by private insurance companies and include all benefits of Part A and Part B. Medicare Advantage works with a network of providers.

Medicare Advantage Plans, sometimes called Part C or MA Plans, are a popular choice for many. Here’s why they might be worth considering:

Comprehensive Coverage Option: They provide "all in one" coverage that includes Part A, Part B, and often Part D for prescription drug coverage.
Extra Benefits: Plans may also offer benefits not covered by Original Medicare, like vision, hearing, dental, and wellness programs.
Lower Costs: Although you'll still pay the Part B premium, Medicare Advantage Plans often have lower out-of-pocket costs and deductibles.

Enrolling in a Medicare Advantage Plan means you must enroll in Original Medicare first, including both Part A and Part B. Here's why:

Required for Enrollment: To join a Medicare Advantage Plan, you need to have both Parts A and B.
Benefits Coordination: The plan will pay instead of Original Medicare, but you’ll pay nothing extra beyond the Part B premium.
Plan’s Network and Service Area: The plan’s network can limit your choice of doctors and hospitals, but they coordinate care to reduce unnecessary services.

The Medicare Advantage Open Enrollment Period runs from January 1 to March 31 each year. During this time, you can:

Switch from one Medicare Advantage Plan to another.
Drop your Medicare Advantage Plan and return to Original Medicare.
Add a standalone prescription drug plan if you switch back to Original Medicare.

Choosing between Original Medicare and Medicare Advantage depends on your health needs and financial situation:

Flexibility: Original Medicare allows you to see any doctor that accepts Medicare, while Medicare Advantage may require you to use the plan's network.
Coverage: Medicare Advantage Plans offer more comprehensive coverage options with extra benefits.
Costs: While Original Medicare may have higher co-insurance and deductibles, the out-of-pocket costs in Medicare Advantage are capped once the annual limit is reached.