Medicare Part C, also known as Medicare Advantage (MA), is health care coverage offered by private insurance companies as an alternative to Original Medicare. These offer the same benefits of Part A and Part B (link to page), and include additional health care coverage in one convenient plan such as an HMO or PPO.
Most Medicare Advantage plans offer Part D (link to page) prescription drug coverage. Additional benefits – such as vision, hearing and dental coverage – are also often included in MA plans, though benefits vary by plan. Many individuals turn to MA plans for their convenience, flexibility and provider freedom. However, please note that members must generally stay within a network of doctors and hospitals.
Depending on your specific needs, Medicare Part C may be an attractive option for you – our representatives in Cary would love to walk you through your options and help you determine what plan is best for you.
Cost of Medicare Part C
Pricing for Medicare Part C varies greatly by plan, but those enrolled in MA plans are responsible for co-pays and/or coinsurance for most services.
Some MA plans have a $0 monthly premium. Regardless of a MA plan’s premium, enrollees are still responsible for paying Medicare Part B premiums.
Additionally, MA plans have an annual out-of-pocket maximum, excluding drug coverage.
Eligibility and Enrollment for Medicare Advantage Plans
Medicare Advantage plans are available to those enrolled in Medicare Part A and Part B, who live in the particular MA plan’s service area, and who do not have End-Stage Renal Disease.
Generally, you may only join or terminate a MA plan during an Initial Enrollment Period or Annual Enrollment Period – or, if you qualify for a Special Enrollment Period.
Please note that Supplemental Insurance policies, or Medigap, cannot be combined with a Medicare Advantage Plan. Likewise, those with MA plans may not have a stand-alone Part D plan.