The Difference Between Medicare and Medicare Advantage 

In this blog post, we explore the differences between Medicare and Medicare Advantage coverages and, most importantly, how to not lose money when dealing with these payers by making the right decision on who to bill. You will also find two free resources for your home health agency, a complimentary PDF Guide that explores the detailed differences in coverages, as well as a video message from our Vice President of Post-Acute Revenue Cycle Management who walks you through your options and explains the importance of choosing which payer to bill.  

What is Medicare?  

Medicare is a government-run health insurance program for people who are 65 years or older, or those with certain disabilities. It covers a range of healthcare services, including hospital stays, doctor visits, and prescription drugs. 

What is Medicare Advantage? 

Medicare Advantage, also known as Medicare HMO, Medicare Replacement Plan, or Medicare Part C, is a type of health insurance plan offered by private insurance companies approved by Medicare. These plans are an alternative to traditional Medicare and offer additional benefits like vision, dental, and hearing coverage, as well as some fitness programs. 

When a patient enrolls in a Medicare Advantage plan, they still have Medicare, but the patients’ healthcare benefits are provided through the private insurance company rather than directly by the government. Additionally, Medicare Advantage plans may have different costs, networks, and rules than traditional Medicare, so it's important to be aware of that as a home health agency. 

What is the right payer to bill between Medicare and Medicare Advantage? 

Watch our video now to learn the answer to this question directly from Lynn Labarta, SimiTree Vice President of Post-Acute Revenue Cycle Management, and keep reading for more information. 

Navigating the healthcare system is complicated for a variety of operational and clinical reasons, regardless of your agency size. Things get even trickier thanks to your multiple options for Medicare and Medicare Advantage, and that’s why we have created a free PDF download that provides an in-depth comparison between the two programs. 

Our PDF, “Differences Between Original Medicare and Medicare Advantage" will be your guide to ensure you bill the right insurance and speed up your payments. Submit your email and we will send it to your inbox immediately.  

How SimiTree Can Help 

We know that you are committed to providing the best possible care to your clients, and understanding the healthcare options available to them is a crucial part of that. To learn more about our home health and hospice revenue cycle management solutions and to get in touch with our experts, visit our website or call us today at 1.800.949.0388. For a consultation, fill out a contact form below. 


Contact Us

Let's work together to improve the health of your organization. At SimiTree, we balance financial expertise and clinical excellence to help our clients grow. How can we help you? Call us at 866.839.5471 or complete the form below.