Parts of Medicare basics – Part C (Medicare Advantage)

The best place to start learning about Medicare is with the basics – with Parts A, B, C and D. The third in a four-blog series, this month’s “Medicare Basics” blog will focus on Medicare Part C, which is also known as Medicare Advantage.

Medicare Advantage is an alternative to Original Medicare (Parts A & B). These are all-in-one plans and are only provided by Medicare-approved private insurance companies.

Part C (Medicare Advantage) was originally added to the Medicare program by Congress to provide Medicare beneficiaries with more coverage choices. Medicare Advantage plans include all the coverage that Medicare Parts A and B provide as well as additional benefits.

Additional benefits provided by Medicare Advantage plans may include, but are not limited to:

• Prescription drug coverage
• Dental
• Vision
• Hearing
• Fitness and gym memberships
• Health and wellness programs
• Nursing helpline

Medicare Advantage plans are not equal though. Plans can vary in terms of covered health benefits based on the plan provider and your location. You’ll want to make sure to look at what each available plan provides and how it may fit your health and lifestyle needs before selecting one. Here are some reasons why choosing a Medicare Advantage plan may be a good idea.

Just like the additional benefits offered, the total cost of a Medicare Advantage plan will vary by provider, location and which plan you choose. For example, some Medicare Advantage plans may come with low-cost monthly premiums, while others may be $0. A plan’s deductible, copayment and coinsurance costs will also vary by plan, and potentially also by the health service or benefit you use.

However, there is a unique benefit to Medicare Advantage plans that other Medicare plans don’t have. All Medicare Advantage plans have a yearly limit on the out-of-pocket costs you must pay for covered medical services. This limit may vary for different plans, and can change each year; however, it’s something that only Medicare Advantage plans offer to help keep costs in check.

It’s important to know that even with a Medicare Advantage plan, you’ll still pay the Part B premium to Medicare.

Enrolling in a Medicare Advantage (Part C) plan is different from enrolling in Original Medicare (Parts A & B). First, before you can enroll in a Part C plan, you must already be enrolled in Part A and Part B. Second, you’ll need to find a Medicare plan provider and enroll directly with them. Medicare Advantage plans are only provided by private insurance companies and are not sold by the government.

Medicare Advantage plans are diverse and unique, so here are some key things to remember.

• Medicare Advantage plans are provided by private insurers only.
• You must be enrolled in Medicare Part A and Part B before you can enroll in Part C.
• Medicare Advantage plans include coverage for items under Medicare Part A and B and may include coverage for other health care benefits such as prescriptions drugs, dental and vison.
• Costs, plan benefits and plan availability vary by plan provider and geographical location.
• All Medicare Advantage plans have an annual out-of-pocket maximum.