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What is Medicare Part C (Medicare Advantage Plan)?

[fa icon="calendar"] May 24, 2017 11:28:35 AM / by Stephanie Pogue

Stephanie Pogue

Medicare Part C combines Medicare Parts A (Hospital), B (Doctor and Outpatient) and D (Prescriptions) together. It is most often called a Medicare Advantage plan, an HMO or a PPO.

Medicare Advantage plans are offered by private insurance companies and have to cover at least the same services as basic Medicare. Typically, they also offer additional coverage so your deductibles and copays are significantly lower than they are on Medicare Parts A and B alone. Medicare Advantage plans also include “extra benefits” like basic dental and vision coverage, hearing aid discounts, transportation to and from medical appointments and fitness benefits such as Silver Sneakers.

Monthly Premium Amounts

The monthly premium amount is usually low, or non-existent in many cases. The premium amount depends on where you live and which plans are offered in your area. Since you need to be enrolled in Medicare Part B to enroll in an  Advantage plan, you will still pay the monthly Part B premium ($134 in 2017) in addition to the plan premium.

It’s important to check all of the Medicare Advantage plans in your area to find out which is best for you. The premium, deductibles, copays, prescriptions covered, and extra benefits offered are different for each plan. Because the coverage varies widely between plans, it’s helpful to speak to a licensed insurance agent to help compare plans in your area.

Other Potential Costs

You also need to make sure your providers are in the plan’s network. If you are in an HMO plan and receive services from a provider outside of the network, the plan will not pay for the service. That means you will be obligated to pay for the entire cost. PPO’s allow you to go to doctors outside of the network but the cost for those services is much higher than an in-network service.

Enrollment Periods

The initial enrollment period for Medicare Advantage plans starts 3 months prior to your 65th birth month and lasts through 3 months after your 65th birth month. Once you enroll in a Medciare Advantage plan, you can only change during the Annual Election Period at the end of each year.

Related Posts: What Does Medicare Part A Cover?,  What is Medicare Part B and what does it cover?

Compare Your Options

You can review your plan options on Medicare.gov or by speaking to an independent insurance agent who is able to offer multiple plans. Keep in mind if you speak to an agent who only offers one company, they will not be able to compare the plans for you.

If you would like a free, no obligation comparison, you can contact us at your convenience.

 

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Topics: Medicare

Stephanie Pogue

Written by Stephanie Pogue

Stephanie has been primarily helping seniors and retirees with their healthcare decisions since 1995. In addition, she has recruited and trained agents, developed and promoted managers, and ranked in the Top 3% of Sales Managers at Bankers Life & Casualty while she was there. She is now the Director of the St. Louis Insurance Group and can be reached by email at s.pogue@stlouisinsurancegroup.com.

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