Know the Difference Between Medicare and Medicare Advantage

If your phone has been ringing nonstop lately with offers for Medicare Advantage plans, you’re not alone. Wisconsin Senior Medicare Patrol Program Director Ingrid Kundinger says that’s because it’s open enrollment season, and confusion about Medicare options is everywhere.

“Your friend getting 20-plus calls a day isn’t unusual right now,” Kundinger says. “But Medicare and Medicare Advantage are not the same thing — and understanding that difference is really important.”

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Listen to a discussion about Medicare options here:

[podcast src="https://civicmedia.us/shows/matenaer-on-air/2025/11/10/navigating-the-maze-of-medicare-choices"]

Kundinger explains traditional Medicare is a federal health insurance program available to people 65 and older. It covers about 80% of most medical expenses, with many people buying a supplemental “Medigap” policy to cover the rest. However, original Medicare doesn’t include vision, dental, or hearing coverage, and prescription drug plans must be purchased separately.

Medicare Advantage plans, on the other hand, are offered by private insurance companies. It combines many of those coverages and sometimes extra perks like transportation or pharmacy cards into one plan. But those benefits come with trade-offs.

“There’s a lot of fine print,” Kundinger warns. “You might find your doctor isn’t in the plan’s network or that your prescriptions aren’t covered the same way they were before. People get caught off guard.”

Open enrollment runs through December 7th. It’s when Medicare users can make changes to their coverage, switch between Advantage and traditional plans, or adjust prescription drug options.

Kundinger advises if you are considering changes — to be patient, do your research, and avoid high-pressure sales calls.

“You don’t need to answer those calls. Instead, connect with a trusted local insurance agent or your Aging and Disability Resource Center,” she says. “They can help you make an informed decision — without trying to sell you something.”