What is Medicare Part C (Medicare Advantage)?
- Jacob Hollingsworth
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- May 9
- 3 min read
Medicare Part C, also known as Medicare Advantage, is an alternative way to receive your Medicare benefits. It’s offered by private insurance companies approved by the Centers for Medicare & Medicaid (CMS). Medicare Part C is required to offer the standard, substantial benefits of Medicare Part A & B, but plans may also offer additional benefits.
Medicare Part C is required to offer Part A (hospital insurance) and Part B (medical insurance) benefits. When you enroll in a Medicare Advantage plan, you will be relinquishing the Original Medicare Plans of A & B for a plan that may offer additional essentials such as Dental & Vision. Bonus benefits such as gym memberships and more may accompany some policies as perks.
Detailed Layout of Key Features of Medicare Advantage Plans
All-in-One Coverage: Some Medicare Advantage plans may bundle Part A, Part B, and Part D (prescription drug coverage) into a single plan. These are called ‘Medicare Advantage Prescription Drug Plans’, or MAPD Plans.
Extra Benefits: Many Medicare Advantage plans offer additional benefits not covered by Original Medicare, such as:
Vision coverage
Dental coverage
Hearing coverage
Wellness programs
Transportation to medical appointments
Different Plan Types: There are various types of Medicare Advantage plans, including:
Health Maintenance Organizations (HMOs): Typically require you to choose a primary care physician and stay within the plan's network of providers.
Preferred Provider Organizations (PPOs): Offer more flexibility to see out-of-network providers, though you'll usually pay more.
Private Fee-for-Service (PFFS) Plans: Determine how much they will pay providers and how much you will pay when you get care. You are able to consult providers out-of-network, but at a higher cost.
Special Needs Plans (SNPs): Designed for people with specific chronic conditions, disabilities, or who are living in long-term care facilities. Enrollment for these plans vary, and we will discuss further later during the enrollment portion of this blog.
COSTS
While Medicare Advantage plans must cover the same basic benefits as Original Medicare, they can have different costs, including:
Premiums
Deductibles
Copayments
Coinsurance
Maximum out-of-pocket limits (Be aware, max out-of-pockets costs may/can generally change from year to year.)
How Does Medicare Part C Work and How Do You Make the Most of It?
When you enroll in a Medicare Advantage plan, you’ll still be considered a Medicare beneficiary, but your coverage will be provided by the private insurance company. The plan will typically have a network of doctors, hospitals, and other healthcare providers that work in tandem, or through co-participation with your insurance provider to provide essential coverage. Your insurance broker is an essential part of this process. Read this blog to learn more about how important it is to consult a licensed insurance broker.
Advantages of Medicare Part C
Convenience: Having all your coverage in one plan can simplify healthcare management. But this does not mean it requires less than full attention.
Extra Benefits: The additional coverage for vision, dental, and hearing can be a significant advantage.
Potential Cost Savings: Some Medicare Advantage plans may have lower out-of-pocket costs compared to Original Medicare with a separate Part D plan and a Medigap policy.
Reliable Referral Network: The convenience of comfort knowing critical coverage blankets are in place and available when the need is required with various options from doctors, dentists, physicians and more. Some plans may not require a referral to see certain specialists.
Key Takeaways
Medicare Advantage is a way to stay proactive and receive complete coverage including bonus benefits to accompany the foundations provided with Medicare Parts A & B.
This information is for general knowledge and should not be considered medical or legal advice. Reach out to us for more information on how we can assist you and provide specified direction for you and your healthcare.
If this matter is pressing you today, consult an Insurance Broker today. "Why put off for tomorrow what you can do today."
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