Medicare Overview
Medicare Part C
Navigating the different Medicare options can seem like a lot to handle, but we’re here to guide you through it. This guide will focus on Medicare Part C, also known as Medicare Advantage. Our goal is to give you a clear, simple overview so you can understand this choice and decide if it’s the right fit for you.
Keep reading or jump to our Highlights and Frequently Asked Questions.
What is Medicare Part C?
Medicare Part C, more commonly called Medicare Advantage, is an alternative way to receive your Medicare benefits. These plans are offered by private insurance companies approved by Medicare and bundle your Part A (Hospital Insurance) and Part B (Medical Insurance) coverage into one single plan. We’re here to help you understand how they work so you can make a choice with confidence.
What Does Medicare Part C Cover?
Medicare Advantage plans are required to cover everything that Original Medicare (Parts A and B) covers. Many plans also include extra benefits not covered by Original Medicare.
- All Part A and Part B Benefits: Covers inpatient hospital stays, skilled nursing facility care, doctor visits, outpatient care, and preventive services.
- Prescription Drug Coverage (MAPD): Most Medicare Advantage plans include prescription drug coverage, combining your health and drug benefits into one convenient plan.
- Extra Benefits: Many plans offer additional coverage for services that Original Medicare doesn’t, such as routine dental care, vision exams and glasses, hearing aids, and fitness program memberships.
Who Is Eligible for Medicare Part C?
To be eligible for a Medicare Advantage plan, you must meet two main requirements:
- You must be enrolled in both Medicare Part A and Medicare Part B.
- You must live in the service area of the Medicare Advantage plan you want to join.
These plans are available to most people who are eligible for Medicare, including those who qualify by age (65 or older) or due to a disability.
What Are the Costs for Medicare Part C?
Costs for Medicare Advantage plans can vary widely, which makes it important to compare your options.
- Monthly Premiums: Many Medicare Advantage plans have low or even $0 monthly premiums. However, you must continue to pay your monthly Part B premium to Medicare.
- Deductibles, Copayments, and Coinsurance: You will typically pay a copayment or coinsurance for services like doctor visits, hospital stays, and prescription drugs. These amounts differ from plan to plan.
- Out-of-Pocket Maximum: A key feature of Medicare Advantage plans is the annual out-of-pocket maximum. This is a yearly limit on what you’ll spend on covered medical services. Once you reach this limit, the plan pays 100% of covered costs for the rest of the year, offering you important financial protection.
Medicare Can Be Confusing
We understand. That's why we wrote a simple guide to help you decipher the terms, makes sense of the options and gain enough insight to make an informed decision.
If you're not ready to reach out to Bob and the Insurance Connection team, please grab your free copy of The ABC’s & D of Medicare. Learn More
Medicare Part C
Frequently Asked Questions
Can I see any doctor with a Medicare Advantage plan?
It depends on the type of plan. Most Medicare Advantage plans, like HMOs and PPOs, have a network of doctors and hospitals. You will generally have lower out-of-pocket costs if you use providers within the plan’s network. Some plans allow you to see out-of-network providers, but at a higher cost.
Do I still need to pay my Part B premium if I have a Medicare Advantage plan?
Yes. Even if your Medicare Advantage plan has a $0 premium, you must continue to pay your monthly Part B premium to Medicare. The Part C plan provides your health benefits, but your Part B premium keeps your medical insurance active.
How do I choose the right Medicare Advantage plan?
Choosing the right plan involves comparing your options based on your unique needs. You should check that your doctors are in the network, your prescriptions are covered, and the costs fit your budget. We can help you navigate these choices and find a plan tailored to your needs.
Insurance Connection USA is a division of Garrison Enterprises a licensed Insurance agency and not connected with or endorsed by the United States government or the federal Medicare program. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. Medicare has neither reviewed nor endorsed this information. Not connected with or endorsed by the United States government or the federal Medicare program.
Important Highlights
Medicare Part C (Medicare Advantage) is an all-in-one alternative to Original Medicare, offered by private insurance companies.
To enroll, you must have both Part A and Part B and live in the plan’s service area.
Costs vary, but plans offer an out-of-pocket maximum to protect you from high medical expenses.
Contact Medicare Support
Monday – Friday
9:00am – 5:00pm CST
Click to Call:
940-382-4700