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How Much Does Medicare Part C Cost in 2023

10/6/2023

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PictureHow Much Does Medicare Part C Cost in 2023
Medicare Part C, also known as Medicare Advantage, are health plans offered by private insurance companies that contract with Medicare. Medicare Advantage Plans provide the same coverage as Original Medicare Part A and Part B, and many include prescription drug coverage as well. With Medicare Advantage, you assign your Medicare benefits to the private plan, which then administers your healthcare coverage.
In 2023, deciding between Original Medicare and a Medicare Advantage Plan involves understanding the costs. Read on to learn more about Medicare Part C Plans, premiums, out-of-pocket limits, and how to choose the plan that fits your healthcare needs and budget.

What is Medicare Part C?
Medicare Part C refers to Medicare Advantage Plans offered by private insurers. These plans include:
  • HMOs (Health Maintenance Organizations)
  • PPOs (Preferred Provider Organizations)
  • PFFS (Private Fee-for-Service)
  • Special Needs Plans
When you enroll in a Medicare Advantage Plan, you still have Medicare coverage. But instead of Medicare paying healthcare providers directly for Part A and Part B benefits, you receive coverage through your Medicare Advantage Plan.

Medicare Advantage Plans must offer the same benefits as Original Medicare. Many plans offer additional benefits like vision, hearing, dental, and prescription drug coverage.

Medicare Part C Costs in 2023The costs for Medicare Advantage Plans in 2023 include:
  • Monthly premiums
  • Copays or coinsurance
  • Out-of-pocket maximum
  • Prescription drug coverage costs
Medicare Advantage Plans each set their own costs, which varies between insurers and locations. On average in 2023, costs are:

Monthly Premiums
  • $0 premium plans are available in many areas.
  • The average monthly premium cost is about $20.
Copays / Coinsurance
  • Primary care visit copay: $10
  • Specialist visit copay: $50
  • Hospital stay copay per day: $295
Out-of-Pocket Maximum
  • Average out-of-pocket max: $5,100
Prescription Drug Coverage
  • Average monthly premium: $15
  • Copays vary by drug tier, ranging from $0 to $100

In addition to these Medicare Advantage costs, you must continue paying your Medicare Part B premium, which is $164.90 per month in 2023 for most beneficiaries.

How Much Does Medicare Part C Cost Compared to Original Medicare?
Medicare Part C costs are typically lower than Original Medicare. Here's a comparison:

  • Original Medicare has no monthly premium for Part A, but the standard Part B premium costs $164.90 per month.
  • The average Medicare Advantage premium is around $20 per month.
  • Original Medicare has no annual out-of-pocket maximum. Medicare Advantage Plans limit your costs for the year.
  • You need a separate Medicare Prescription Drug Plan with Original Medicare, which has monthly premiums. Medicare Advantage covers drugs.

However, keep in mind Medicare Advantage Plans have copays and coinsurance for covered services. So your out-of-pocket costs at the time of care may be higher compared to Original Medicare's 20% coinsurance with no copays.

Your total healthcare costs for the year may be lower with a Medicare Advantage Plan, but the specific cost sharing differs.

What Does Medicare Part C Cover?
Medicare Part C Plans must cover all of the benefits included under Original Medicare Part A and Part B. This includes:
  • Inpatient hospital stays
  • Outpatient services
  • Preventive services
  • Doctor visits
  • Emergency care
In addition to covering this Original Medicare coverage, most Medicare Advantage Plans include extra benefits such as:
  • Prescription drug coverage
  • Routine vision exams and eye wear
  • Routine hearing exams and hearing aids
  • Dental cleanings and exams
  • Fitness membership
  • Over-the-counter medication allowance
  • Transportation to medical appointments

Always check the full details from a plan on what benefits are included. Certain benefits like dental or vision may be limited in coverage.

How Do I Choose a Medicare Part C Plan?
Choosing a Medicare Advantage Plan involves:
  • Comparing costs like premiums, copays, and drug coverage between plans
  • Ensuring your preferred doctors, hospitals, and pharmacies are in-network
  • Evaluating extra benefits that are important to you
  • Picking a plan type (HMO, PPO, etc) that fits your needs

Use the Medicare Plan Finder tool on Medicare.gov to find and compare Medicare Advantage Plans in your ZIP code. Look for a plan with affordable copays for the services you use, coverage for your medications, and a premium within your budget.

When Can I Sign Up for Medicare Part C?
  • If you're nearing age 65, you can enroll in a Medicare Advantage Plan during your Initial Enrollment Period - the 7 month window around your 65th birthday when you first sign up for Medicare.
  • If you already have Original Medicare, you can switch to a Medicare Advantage Plan during the annual Medicare Open Enrollment Period from October 15 to December 7 each year. Your new coverage starts January 1.
  • There are also Special Enrollment Periods that allow you to switch Medicare Advantage Plans or go back to Original Medicare during certain qualifying events.

Re-evaluate your Medicare Advantage Plan options each Open Enrollment to make sure it still meets your needs for the following year. Costs and coverage can change annually.

What is the Average Cost of Medicare Part C in 2023?
In 2023, the average monthly premium cost for a Medicare Advantage Plan is about $20, in addition to the Medicare Part B premium. The average out-of-pocket maximum is around $5,100 per year.

Actual Medicare Advantage costs vary significantly based on your location and plan. Some key factors include:
  • Type of plan (HMO, PPO, etc)
  • Benefits offered beyond Original Medicare
  • Which doctors and facilities are in-network
  • Monthly premium amount
  • Cost sharing amounts like copays and coinsurance
  • Prescription drug coverage costs

Always compare plans' costs and benefits side-by-side when choosing your Medicare Advantage Plan for the upcoming year. Weigh premiums, copays, drug coverage, and maximum out-of-pocket costs to find an option affordable for your budget.

The Bottom Line on Medicare Part C Cost
Medicare Advantage Plans offer all the benefits of Original Medicare along with added coverage like prescription drugs. By providing this bundled insurance, Medicare Part C offers costs savings and predictable out-of-pocket spending compared to Original Medicare and a separate Part D  Plan.

Carefully compare premiums, benefits, and networks when choosing a Medicare Advantage Plan during open enrollment each year. Select an affordable Medicare Part C Plan that meets your healthcare and budget needs.

We’re Here to Help
You do not have to spend hours reading articles on the internet to get answers to your Medicare questions. Give the licensed insurance agents at The Insurance Space a Call at (866) 717-8683. You will get the answers you seek in a matter of minutes, with no pressure and no sales pitch. We are truly here to help.

FAQS

How much does Medicare Part C cost in 2023? 
The cost of Medicare Part C, also known as a Medicare Advantage Plan, can vary depending on several factors. These factors include your location, the specific plan you choose, and any additional coverage options you select. It's best to review different plans in your area to get an accurate cost estimate.

What is a Medicare Advantage Plan? 
A Medicare Advantage Plan, or Medicare Part C, is a type of health insurance plan offered by private companies that are approved by Medicare. These plans provide all the benefits of Medicare Part A and Part B, and often offer additional coverage such as prescription drugs, dental care, and vision care.

How does the premium for a Medicare Advantage Plan compare to the premium for Medicare Part B? 
The premium for a Medicare Advantage Plan can vary depending on the specific plan you choose. In some cases, the premium for a Medicare Advantage Plan may be lower than the premium for Medicare Part B. It's important to compare plans to ensure you're selecting the best option for your needs and budget.

What are the average Medicare Part C costs in 2023?
The average Medicare Part C costs in 2023 can vary depending on several factors, including the specific plan you choose and your location. It's best to review different plans in your area to get an accurate estimate of the costs associated with Medicare Part C.

Can I get prescription drug coverage with a Medicare Advantage Plan? 
Yes, many Medicare Advantage Plans offer prescription drug coverage as part of their benefits. It's important to review the specifics of each plan to determine if prescription drug coverage is included and what medications are covered.

How do I enroll in Medicare Part C? 
To enroll in Medicare Part C, you can contact the private insurance companies that offer these plans in your area. They will guide you through the enrollment process and help you select the plan that best meets your needs.

What is the difference between Medicare Parts A and B and Medicare Part C? 
Medicare Parts A and B, also known as Original Medicare, provide coverage for hospital services and medical services respectively. Medicare Part C, or Medicare Advantage Plans, are offered by private companies and provide all the benefits of Parts A and B, as well as additional coverage options.

How much does a Medicare Supplement Plan cost? 
The cost of a Medicare Supplement Plan, also known as Medigap, can vary depending on several factors, including your location, age, and health status. It's best to compare plans to get an accurate cost estimate.

What is the average premium for a Medicare Part C plan in 2023? 
The average premium for a Medicare Part C Plan in 2023 can vary depending on several factors, including the specific plan you choose and your location. It's important to review different plans to get an accurate estimate of the premium costs.

How do I choose a Medicare Advantage Plan?
When choosing a Medicare Advantage Plan, it's important to consider factors such as the specific coverage options, network of doctors and hospitals, prescription drug coverage, and cost. You can compare plans in your area and speak with a licensed insurance agent to help you make an informed decision.

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