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Medicare Part C - Medicare Advantage

Medicare Part C, unlike Part A and Part B, is not part of Original Medicare. Medicare Part C plans can be purchased through private insurance providers who are contracted with the federal government. 

Unlike Original Medicare, you do not enroll in Medicare Part C with your Social Security office. Rather, you can sign up with the help of a licensed insurance broker. Reach out to us here at Medicare Plans Direct if you are interested in exploring your Medicare Part C plan options.

What is Medicare Part C?

Medicare Part C is also known as Medicare Advantage. These plans do not replace your Part A and Part B coverage, but rather they become primary to your Original Medicare Coverage. Medicare Advantage policies often include extra benefits, such as drug coverage, hearing coverage, vision coverage, dental coverage, and more.

Though Medicare Part C isn’t for everyone, it is growing in popularity. In fact, it is estimated that by 2030, nearly 70% of all Medicare beneficiaries may choose to enroll in a Medicare Advantage plan

Medicare Advantage Plans

There are many types of Medicare Advantage plans, some of the most popular ones being Health Maintenance Organization (HMO) Plans, Preferred Provider Organization (PPO) Plans, Private Fee-For-Service (PFFS) Plans, Special Needs Plans (SNPs), and Medical Savings Account (MSA) Plans.

Part C plans offer varied benefits and guidelines, so it is important to do your research on a plan before deciding to enroll.

Though finding the right Medicare Advantage policy for you can seem like a daunting task, our team at Medicare Plans Direct can point you in the right direction. Reach out today for a free consultation

What does Medicare Part C cover?

Medicare Part C plans are required to cover just about all of the benefits that Original Medicare (Part A and Part B) covers. Therefore, a Medicare Advantage plan will provide you with coverage for hospitalization, doctor’s visits, ambulance transportation, mental health care, medically necessary equipment, etc

Depending on the Medicare Advantage plan that you choose, your policy may also provide coverage for additional services that aren’t covered under Original Medicare. Plans can include vision, dental, hearing, health and wellness programs, transportation to doctors’ visits, and prescription drug coverage (and in some cases coverage for over-the-counter medications).

How much does Medicare Part C cost?

How much you have to pay for Medicare Part C depends greatly on which type of plan you choose. One benefit of Medicare Advantage plans is that they tend to have lower monthly premiums. In fact, some plans even offer $0 premiums. 

However, that doesn’t mean that Medicare Advantage plans are necessarily the most affordable option out there. Plans often come with yearly deductibles, coinsurance, and copayments.

Plus, if your Medicare Advantage plan has a network and you choose to visit providers that are outside of your plan’s network, you will have to cover some or all of the related expenses.

You should also know that Medicare Advantage plans have yearly out-of-pocket (OOP) maximums. In 2021, that maximum amount is $7,550 for in-network costs and $11,300 for in-and out-of-network combined, though many plans will have lower limits.

Who is eligible for Medicare Part C?

If you are eligible for Original Medicare, you are also eligible for Medicare Part C.* 

However, you have to be enrolled in both Medicare Part A and Part B in order to sign up for a Medicare Advantage plan. If you choose to opt out of Part B, you will no longer qualify for Medicare Part C. 

Finally, once you sign up for a Medicare Advantage plan, you will not also be able to enroll in a Medigap policy (Medicare Supplement Insurance). 

If you are wondering whether or not a Medicare Advantage could be right for you, get in contact with one of our licensed insurance agents. 

 *Beneficiaries who were eligible for Medicare due to the fact that they suffered from ESRD used to be barred from enrolling in a Medicare Advantage plan. However, they now have the opportunity to do so during the Annual Election Period (October 15-December 7).

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