What Does Medicare Part C Cover?

Understanding Medicare Advantage Plans

When it comes to Medicare, there are various parts to consider. Medicare Part C, also known as Medicare Advantage, is a popular choice for many. But what exactly does a Medicare Advantage Plan cover, and how does it differ from Original Medicare? This guide will provide clarity on these questions and help you make an informed decision.

Types of Medicare Advantage Plans

Medicare Advantage Plans come in different types, each offering various benefits. Here are the main types of Medicare Advantage Plans:

Health Maintenance Organization (HMO)
Preferred Provider Organization (PPO)
Private Fee-for-Service (PFFS)
Special Needs Plans (SNPs)
Medical Savings Account (MSA)

Each type of plan has its own network of doctors and hospitals, coverage rules, and costs. It’s essential to understand these differences when choosing a Medicare Advantage Plan.

What is Medicare Part C?

Medicare Part C, also called Medicare Advantage, is an alternative to Original Medicare (Part A and Part B). These plans are offered by Medicare-approved private insurance companies and provide all your Part A and Part B benefits. Some Medicare Part C plans also include additional benefits like prescription drug coverage, dental, vision, and hearing services.

How to Enroll in a Medicare Advantage Plan

If you’re eligible for Medicare and enrolled in both Medicare Part A and Part B, you can apply for a Medicare Advantage Plan. Here’s how you can enroll:

Visit the Medicare website and use the Plan Finder tool.
Contact the insurance company offering the plan.
Call Medicare at 1-800-MEDICARE (1-800-633-4227).

It’s important to compare different plans and choose a Medicare Advantage Plan that fits your healthcare needs and budget.

Medicare Advantage Plans Cost

The cost of Medicare Advantage Plans can vary based on several factors, including the type of plan, coverage options, and your location. Generally, you may have to pay a monthly premium in addition to your Part B premium. Here are some common costs associated with Medicare Advantage Plans:

Monthly premiums
Deductibles
Copayments and coinsurance

Make sure to review the plan’s cost structure to understand what you’ll be paying out-of-pocket.

What Does Medicare Advantage Cover?

Medicare Advantage Plans cover everything that Original Medicare covers, and often more. Here’s what you can expect:

Hospital services covered by Original Medicare (Part A)
Medical services covered by Original Medicare (Part B)
Prescription drug coverage (Part D), if included in the plan
Additional benefits like dental, vision, and hearing care

Some Medicare Advantage Plans may also offer wellness programs, gym memberships, and transportation to medical appointments.

Difference Between Medicare Advantage and Original Medicare

While both Medicare Advantage and Original Medicare provide essential healthcare coverage, there are key differences:

Provider Networks: Medicare Advantage Plans typically have networks of doctors and hospitals you must use. Original Medicare allows you to see any provider that accepts Medicare.
Coverage Options: Medicare Advantage Plans may offer additional benefits not covered by Original Medicare, such as dental and vision care.
Cost Structure: Medicare Advantage Plans may have lower out-of-pocket costs for certain services, but you may need to pay extra premiums and copayments.

Choosing a Medicare Advantage Plan

When it comes time to choose a Medicare Advantage Plan, consider the following:

Your healthcare needs and the services you use most often
Plan costs, including premiums, deductibles, and copayments
The plan’s network of doctors and hospitals
Additional benefits offered by the plan

Take the time to compare different plans and choose a Medicare Advantage Plan that provides the coverage you need at a price you can afford.

How to Change Your Medicare Advantage Plan

If you’re already enrolled in a Medicare Advantage Plan but want to switch, you can do so during the annual Open Enrollment Period (October 15 to December 7). You can also make changes during the Medicare Advantage Open Enrollment Period (January 1 to March 31) if you’re already enrolled in a Medicare Advantage Plan.

Changing your plan is simple:

Use the Medicare Plan Finder to compare plans.
Contact the new plan to enroll.
Contact Overton Agency at (501) 881-2050 to request a free Medicare Plan Review