Medicare Part C

Medicare Part C / Medicare Advantage Options in South Florida

Medicare Part C

Medicare is a federal health insurance program designed for people over 65 and those with certain disabilities. Medicare has four parts, with Part A (hospital insurance) and Part B (outpatient services) commonly referred to as Original Medicare. Part A covers inpatient hospital care, hospice care, and skilled nursing facility care. Part B covers medically necessary services like doctor visits, preventive care, and outpatient care.

While Medicare covers many healthcare services, there are gaps in coverage that could leave you with significant out-of-pocket costs.

This is where Medicare Part C, also known as Medicare Advantage Plans, comes in. Medicare Advantage Plans are offered by private insurance companies approved by Medicare.

These plans combine all the benefits of Parts A and B into one plan, and often offer additional benefits that Original Medicare does not cover. You must be enrolled in Parts A and B to join a Medicare Advantage Plan.

Seniors with Medicare Part C - Medicare Advantage Plans

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Although there could be some out-of-pocket expenses (like coinsurance or copayments for certain services), there are many advantages to Medicare Part C:

  • Costs can be less than Original Medicare Plan
  • You may be able to receive additional benefits offered by the plan like coverage for hearing, dental, vision, special discounts on certain health-related products and wellness programs

Advantages of Medicare Advantage Plans

One advantage of Medicare Advantage Plans is that they often have lower out-of-pocket costs than Original Medicare. While Original Medicare has no limit on out-of-pocket costs, Medicare Advantage Plans do have a cap on the amount you would pay in a given year for covered services.

Once you reach this cap, your plan covers 100% of your healthcare costs for the rest of the year. 

Another advantage of Medicare Advantage Plans is the added benefits they often provide. These can include coverage for dental exams, vision, and hearing aids, as well as fitness and wellness programs. Benefits vary depending on which C Plans you choose.

What does Medicare Part C Cover?

Medicare Part C covers all the services provided by Parts A and B. This includes inpatient hospital care, skilled nursing facility care, doctor visits, preventive care, and outpatient care. However, instead of paying the deductibles and coinsurance associated with Original Medicare, you would only pay the plan’s copays for covered plan services.

Most Medicare Advantage Plans also include prescription coverage, Part D. This means you would not need to enroll in a separate Part D plan to get prescription coverage. It’s important to note that every Medicare Advantage Plan is different, and the benefits and costs can vary widely. Be sure to carefully review the plan’s details before enrolling.

Types of Medicare Advantage Plans

There are several types of Medicare Advantage Plans to choose from. Remember none of them offer the same coverage. All plans cover non-urgent medically necessary care outlined in the summary of benefits.

Enrollment in Medicare Part C

To enroll in a Medicare Advantage plan, you must have Medicare Parts A and B and live in the plan’s service area. 

You can enroll in a Medicare Advantage plan during the initial enrollment period (IEP), which is a seven-month period that begins three months before you turn 65 and ends three months after the month of your 65th birthday. You can also enroll during the annual enrollment period (AEP), which runs from October 15 to December 7 each year.

If you want to change your Medicare Advantage plan, you can do so during the open enrollment period (OEP), which runs from January 1 to March 31 each year. During this time, you can switch from one Medicare Advantage plan to another or switch from a Medicare Advantage plan to Original Medicare. These dates come from the Federal Government as do elder affairs.

Conclusion

Medicare Part C, or Medicare Advantage plans, can provide additional benefits and lower costs compared to Original Medicare. These plans include all of the services covered by Original Medicare and often include Part D prescription drug plans and additional benefits like dental, vision, and hearing coverage.

There are different varieties of Medicare Advantage plans, including PPO, HMO, and MSA that  you can purchase additionally for dental, vision, hearing, and more.

If you’re trying to choose a Medicare Advantage(MA) Plan, be sure to carefully review the plan’s benefits, networks, health care administration and costs to ensure it’s the right plan for you. Avoid scams and only work with licensed Health Care professionals. For a question on MA Plans or for Under 65 Medical Insurance please give us a call at 954-282-6891.

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