Last Updated on January 30, 2023 by Tabraiz
Medicare Advantage Plans Part C
Medicare Advantage Plans and Part C are one and the same. In order to enroll in Medicare Part C, you must first be enrolled in Medicare Parts A and B. All of the same restrictions and guidelines that determine who is eligible for Parts A and B also apply to all those enrolling in Part C. Though this plan is provided by Medicare, it is furnished through an independent insurance provider. Parts A and B are paid for through the Medicare Supplement Plan G, which is funded through Social Security tax and budget appropriations. While Part C is not separate from Medicare itself, this plan does allow more freedom of choice about who manages your insurance and what benefits you receive.
What Part C Cover?
Medicare Advantage Plans or Part C Plans will differ slightly depending on from which company you end up receiving coverage; however, most providers offer plans to cover hospital stays, nursing homes, and medically related home visits. All of the same benefits under Medicare Plans A and B are generally provided by the companies that specialize in these private health care plans. While this is true, each insurance company sets its own rules, premiums, and restrictions. For some, this may be a disadvantage, as the rates may be higher than standard Medicare. On the other hand, reflecting the “Medicare Advantage” name, this may be a serious improvement over an individual’s standard Medicare rates.
What Part C Plans Are Available?
Many insurance companies over privately held variations of Medicare Parts A and B to cover a range of needs, except hospice, which is covered by original Medicare, even if you prefer to be covered by a Part C or Advantage plan. Which plan you ultimately choose will depend heavily on which doctors and hospitals you prefer to visit, whether those providers are in a specific plan’s network, and what rate you are willing to pay for your coverage. For PPO (Preferred Provider Organization) and HMO (Health Maintenance Organizations), you must choose doctors in your plan’s network, or your costs for visiting those doctors will rise.
Why Enroll in Medicare Part C?
Medicare Part C offers those who prefer to purchase an insurance plan from a private company and still obtain all of the same benefits as those in original Medicare. Advantage Plans may also provide benefits that original Medicare does not, such as coverage for vision, hearing, dental, and wellness programs. Instead of having to pay for each of these services individually, they can be rolled into your plan. Though you are not automatically enrolled in Medicare Part D, this is often a part of these Advantage Plans, in order to ensure you have the prescription drug coverage that you need.
While Part C must cover all the medically necessary services that Medicare provides, your Advantage Plan may not cover all of the other services. Before you have any procedure, call your provider and ask that your plan provide you with a written statement concerning whether or not they will cover the service. These decisions can be appealed.