To learn about Medicare, it’s best to start with the basics – with Parts A, B, C, and D. This month’s “Medicare Basics” blog, the third in a series of four articles, will focus on Medicare Part C, also known as Medicare Advantage.
Medicare Advantage is an alternative to Original Medicare (Parts A and B). They are all-in-one plans and are only provided by private insurance companies approved by Medicare.
What Medicare Part C (Medicare Advantage) Covers
Part C (Medicare Advantage) was originally added to the Medicare program by Congress to give Medicare beneficiaries more coverage options Like PPO Plans. Medicare Advantage plans include all the coverage provided by Medicare Parts A and B, as well as additional benefits.
Additional benefits provided by Medicare Advantage plans may include, but are not limited to:
- Prescription Drug Coverage
- dental services
- vision services
- hearing services
- Membership in a gym or fitness center
- Health and wellness programs
- Nurse Helpline
However, Medicare Advantage plans are not all the same. They can vary in what health benefits they cover, depending on the plan provider and where you live. We recommend that before you choose a plan, you make sure to review what each available plan offers and whether it fits your health and lifestyle needs.
How Much Does Medicare Advantage Cost?
As well as the extra benefits it offers, the total cost of a Medicare Advantage plan varies depending on the provider, location and plan you choose. For example, some Medicare Advantage plans might include low-cost monthly premiums, while others might have $0 premiums. A plan’s deductible and copayment and coinsurance costs vary by plan, and possibly also by the health service or benefit you use.
However, there is one unique benefit that Medicare Advantage plans offer that other Medicare plans don’t. All Medicare Advantage plans have an annual out-of-pocket limit, which is the most you have to pay for covered medical services. This limit can vary between different plans and can change every year; however, it is something only Medicare Advantage plans offer to help keep costs down.
It’s important to know that even with a Medicare Advantage plan, you’ll still have to pay your Medicare Part B premium.
How Do I Get Medicare Part C?
Enrollment in a Medicare Advantage plan (Part C) is different from enrollment in Original Medicare (Parts A and B). First, before you can enroll in a Part C plan, you must already be enrolled in Part A and Part B. Second, you will need to find a Medicare plan provider and enroll directly with them. Medicare Advantage plans are provided only by private insurance companies, not sold by the government.
NOTE: If you’re also considering a Medigap (Medicare Supplement Insurance) plan, you should know that you can’t join a Medicare Advantage plan as well as Medigap. You can only have one of them at a time.
What to Remember About Medicare Advantage Plans
Medicare Advantage plans are diverse and unique, so some important things to remember are:
- Medicare Advantage plans are provided only by private insurance companies.
- You must sign up for Medicare Part A and Part B before you can sign up for Part C.
- Medicare Advantage plans include coverage for items covered by Medicare Parts A and B, and may include coverage for other health care benefits such as prescription drugs, dental and vision services.
- Costs, plan benefits, and plan availability vary by plan provider and geographic location.
- You cannot have a Medicare Advantage Plan and a Medigap (Medicare Supplement Insurance) plan at the same time.
- All Medicare Advantage plans have an out-of-pocket limit.
Finally, if you’d like to take a closer look at Part C, contact us today with your questions.
