What is Medicare Part C (Medicare Advantage Plans)?

Medicare Part C, also known as “Medicare Advantage” is a type of private health insurance plan that provides additional benefits beyond Original Medicare Parts A and B.

What is Medicare Advantage?

Medicare Advantage is a Medicare program that allows private insurance companies to offer health insurance plans that provide the same or better benefits than Original Medicare. These plans offer the same services as Part A and B, but may also include additional benefits such as vision, dental, and prescription drug coverage. A Medicare Part C Plan is different type of Medicare coverage than a Medicare Supplement Plan.

Read More about Medicare Supplement Plans Here.

How is Medicare Advantage different from Original Medicare?

Medicare Advantage differs from original Medicare in several ways. One major difference is that Medicare Advantage is offered through private insurance companies as a replacement to Original Medicare, whereas original Medicare is run by the federal government. Additionally, Medicare Advantage plans may have different costs and coverage than original Medicare. Lastly, Medicare Advantage plans in your area could offer additional benefits that are not covered by original Medicare, such as vision and dental.

What are the different types of Medicare Advantage plans?

There are several kinds of Medicare Advantage plans, including Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), and Private Fee-for-Service (PFFS) plans. HMO Plans typically require you to choose a primary care physician, and require a referral to see a specialist. PPO Plans, on the other hand, usually do not require a referral to see a specialist, but may have higher out-of-pocket costs. PFFS plans allow you to receive care from any healthcare provider who accepts the plan’s payment.

What extra benefits do Medicare Advantage plans cover?

Medicare Advantage, or Medicare Part C, plans provide extra benefits beyond original Medicare, such as vision, dental, and Medicare Advantage prescription drug coverage. Some plans may also offer wellness programs, transportation, and over-the-counter medication coverage. It’s important to review the plan’s specific coverage to determine if it meets your needs.

Enrolling in Medicare Advantage

When can I enroll in Medicare Advantage?

The initial enrollment period for Medicare is three months before you turn 65, the month you turn 65, and the three months after you turn 65. After that, you can enroll during the annual Medicare Advantage annual enrollment period from October 15th to December 7th each year. Additionally, you may qualify for a special enrollment period if you experience certain life events, such as moving or losing employer coverage.

After you have chosen a plan and are already in enrolled in a plan, you may change your plan annually during the annual enrollment period or the Medicare Advantage Open Enrollment Period (OEP) that runs from January 1 to March 31 each year. When you switch to another Medicare Advantage Plan, your benefits, co-pays, and deductibles may also change.

How do I enroll in a Medicare Advantage plan?

To enroll in a Medicare Advantage plan, also referred to as Medicare Part C, you must first be enrolled in both Part A and Part B of Medicare. You can then compare and select a plan that meets your needs. You can enroll online, by phone, or through an insurance agent.

Can I enroll in a Medicare Advantage plan if I already have Medicare?

Yes, if you are already enrolled in original Medicare, you can choose to enroll in a Medicare Advantage plan during the annual enrollment period. It’s important to review the plan’s coverage and costs to ensure it meets your needs.

Understanding Medicare Advantage Costs

What are the out-of-pocket costs for Medicare Advantage?

Out-of-pocket costs for Medicare Advantage may include copayments, coinsurance, deductibles, and monthly premiums. These costs may vary depending on the plan and the services received. It’s important to review the plan’s specific cost structure to determine what you will be responsible for paying. Medicare Advantage plans also cap your out-of-pocket costs whereas Original Medicare does not.

How does Medicare Advantage affect my Part A and Part B coverage?

Medicare Advantage plans are required to  provide the same coverage as Part A and B, and may also provide additional benefits. The comprehensive coverage of a Medicare Advantage Plan might be a good fit for people who prioritize additional benefits.  However, if you enroll in a Part C plan, you will still be enrolled in Medicare Part A and Medicare Part B and must continue to pay your Part B premiums.

Do Medicare Advantage plans also include prescription drug coverage?

Some Medicare Advantage plans do include prescription drug coverage, while others do not. It’s important to review the plan’s specific coverage to determine if prescription drug coverage is included because you can not also have a Part D plan.

Comparing Medicare Advantage Plans

What should I consider when choosing a Medicare Advantage plan?

When choosing a Medicare Advantage plan, it’s important to consider the plan’s costs, coverage, and benefits. You should also consider the provider network and whether your healthcare providers are included in the plan. Lastly, you should review the plan’s star rating which provides a rating for the plan’s customer service, health services, and drug services.

How much does Medicare Advantage cost?

The cost, or premium, for a Medicare Advantage plan, varies depending on the plan and the benefits provided. Some plans may have lower premiums but higher out-of-pocket costs, while others may have higher premiums with lower out-of-pocket costs. It’s important to review the plan’s costs and coverage to determine what works best for your budget and healthcare needs.

Am I eligible for Medicare Advantage (Part C)?

To be eligible for Part C you must first be enrolled in both Medicare Part A and Part B. Additionally, you must live in an area where the plan is offered.

What is the initial enrollment period for Medicare?

The initial enrollment period for Medicare is three months before and after your 65th birthday. During this time, you can enroll in both Part A and Part B of Medicare.

How do I apply for Medicare Advantage?

To apply for Medicare Advantage, you can enroll online, by phone, or through an insurance agent. Remember to review the plan’s costs and coverage before enrolling. Choosing a plan and enrolling in Medicare Part C is a significant decision due to the complexities of provider networks, plan benefits, and prescription drug coverages.

We are here to help.

The licensed senior health insurance agents at American Entitlements are well trained in evaluating the differences of each plan and are ready to help you learn more about Medicare Part C plans. The Medicare Insurance Agents at American Entitlements can even help you sign up for Medicare and enroll in a Medicare Part C plan.

We will help to find plans that include your medical providers, prescription drugs, and additional benefits that suit you.

If you are already enrolled in Medicare or a Part C Plan, call us anyway. We offer Medicare plans from the highest rated companies and are happy to provide a no obligation plan comparison. After all, not every plan is the same.

Give us a call now at 469-814-0289 or schedule a call with us by visiting our Contact page.