Medicare Part C is also known as 'Medicare Advantage.' Medicare Advantage is placing your Original Medicare in the hands of a private insurance company. The private carrier would then handle your benefits and claims instead of the federal government.
These plans are required to provide coverage that is equal to or better than that of Original Medicare. Unlike Original Medicare, Medicare Advantage plans are required to have a Maximum Out of Pocket for your copays and/or coinsurance.
The Medicare Advantage policies are required to cover at least as much as Original Medicare, unless you go out of the Medicare Advantages plan network. Learn about Medicare Advantage Networks and plan type here.
Medicare Part C (Medicare Advantage) must cover all services that are covered under Medicare Part A and B of Original Medicare. Most Medicare Advantage plans will include additional benefits not provided under Original Medicare such as dental, vision, hearing, gum membership, over the counter items, and more.
Prescription Drugs are covered by most Medicare Advantage Plans, however there are plans that do not cover Prescription Drugs. Those Medicare Advantage Plans that do not provide Prescription Drug coverage may allow a stand-alone Prescription Drug Plan to be purchased in addition to the Medicare Advantage Plan.
Some Medicare Advantage Plans offer Dental, Vision, and Hearing benefits. Since, Medicare Advantage is allowed to offer coverage equal to or greater than Original Medicare, many extra benefits have been built into the Medicare Advantage Plans. Some of the Medicare Advantage Plans offer gym memberships, a subsidy for over-the-counter medications and vitamins as well as other benefits. Many plans will even offer transportation assistance.
Medicare Part C (Medicare Advantage) plans cover the following preventative care services:
To enroll in Medicare Part C (Medicare Advantage) you must have both Medicare Part A and Medicare Part B to be eligible for a Medicare Advantage Plan. If, you cancel your Medicare Part A or B then your Medicare Advantage Plan would be cancelled.
Enrollment for Medicare Advantage can happen after you receive your Medicare Card. You are able to enroll in a Medicare Advantage Plan 3 months prior to your 65th Birthday, the month of your 65th Birthday, and 3 months after your 65th Birthday. After, that enrollment period is over you are able to enroll in a Medicare Advantage Plan every year during October 15th - December 7th. There are also, Special Election Periods that occur throughout each year that will allow you to enroll in a Medicare Advantage Plan.
The only health question that can disqualify you from enrolling in a Medicare Advantage is, "Do you have End-Stage Renal Disease?" Unless you develop End-Stage Renal Disease while on a Medicare Advantage plan, you will not be able to select this coverage.
However, as of 2021 this health question can no longer be asked and there will no longer be any health screening questions. You can have a serious illness, in the middle of cancer treatments, or in the hospital and you will be able to change your enrollment for Medicare Advantage during the Annual Enrollment Period, which is October 15th - December 7th of every year.
Medicare Advantage cost can vary from $0 to over $100 monthly premium depending on the Medicare Advantage plan you choose. The Medicare Advantage plan premium is in addition to your Medicare Part B monthly premium. If you are unsure of your Medicare Part B premiums, take a look at this.
You Must have both Medicare Part A and Part B, so you must have your Monthly Part B premium paid to have a Medicare Advantage Plan in place. The cost of your Medicare Advantage plan will vary based on your county in which you reside, this also is going to determine the types of plan options you have available.
With the Medicare Advantage Plan having a low monthly cost the Out of Pocket expenses will vary. Your healthcare expenses go up and down with usage as you pay a copay or coinsurance for services. Medicare is a 'Pay as you go' option.