Medicare Part C, also known as Medicare Advantage, provides an alternate way for Medicare beneficiaries to receive their Medicare coverage through private health plans. Part C has become an extremely popular option, with over 28 million enrollees as of 2023.
In this comprehensive guide, we’ll explain what Medicare Part C is, what benefits it includes, who is eligible to enroll, when you can sign up, and how it differs from Original Medicare. Whether you are approaching Medicare eligibility or already enrolled, understanding Part C is key to making the right coverage decisions.
What is Medicare Part C?
Medicare Part C refers to Medicare Advantage Plans. These are health plans offered by private insurance companies that have contracts with Medicare to provide all your Part A and Part B benefits. Medicare pays these companies a set fee per enrollee to provide coverage.
Some key facts about Medicare Advantage Plans:
These plans bundle all the coverage provided by Original Medicare and frequently offer additional benefits Original Medicare doesn’t cover. We’ll go over those added benefits in more detail shortly.
What Does Medicare Part C Cover?
Medicare Part C covers everything that Original Medicare does and more. By law, all Medicare Advantage Plans must provide at least the same level of coverage for hospital and medical services that you would get with Parts A and B.
Some of the core benefits covered by Part C plans include:
For example, getting prescription drug coverage through a Part C plan means you don’t have to purchase a separate Medicare Part D drug plan. The same goes for dental coverage – you don’t have to find a standalone policy to cover cleanings, exams, and procedures.
How Does Medicare Part C Differ from Original Medicare?
While Part C plans cover all of the same services as Original Medicare, there are some key differences between the two coverage options:
Who is Eligible to Enroll in Part C?
To enroll in a Medicare Part C Plan, also called a Medicare Advantage Plan, you must meet some basic eligibility requirements:
When Can You Sign Up for Medicare Part C?
There are a few different enrollment periods when you can sign up for a Medicare Part C Plan:
Initial Enrollment Period – When you first become eligible for Medicare at age 65, your Initial Enrollment Period is a 7-month window to enroll that includes the 3 months before, the month of, and 3 months following your 65th birthday month.
Annual Enrollment Period – From October 15 to December 7 each year, you can enroll in or change Medicare Part C Plans for coverage effective January 1 of the following year.
Open Enrollment Period – From January 1 to March 31, anyone enrolled in a Medicare Advantage Plan can switch to a different MA plan or disenroll to Original Medicare.
Those are the most common times to sign up for Part C coverage. In most cases, you are locked into your chosen policy for the remainder of the year unless certain special circumstances apply.
Knowing the enrollment period rules will ensure you pick initial coverage or make changes at optimal times.
How Do You Enroll in Medicare Part C?
Enrolling in a Medicare Advantage or Part C Plan is fairly straightforward. During the various enrollment periods:
How Do You Disenroll from Medicare Part C?
To leave a Medicare Advantage Plan, you also must follow specific timeframes:
Common Questions About Medicare Part C
We hope this overview has helped explain what Medicare Part C is used for. Here we've included answers to some frequently asked questions for more details about Medicare Advantage Plans.
What's the difference between Medicare Parts A, B, C and D?
Do Medicare Advantage Plans have provider networks?
Is Medicare Part C free for people with low income?
Can you have Medigap with Medicare Part C?
What's the best Medicare Part C Plan?
We hope this overview has helped explain how Medicare Part C gives beneficiaries an alternate way to receive their Medicare benefits through private health plans. Medicare Advantage provides all the coverage of Original Medicare along with extra benefits and services. If you meet eligibility requirements, Part C plans can be a great option to consider during Medicare enrollment.
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What is Medicare Part C?
Medicare Part C, also known as Medicare Advantage, is a type of medical insurance that is offered by private companies approved by Medicare. It is an alternative to Original Medicare (Medicare Part A and Part B) and may offer additional benefits such as dental care, vision care, and prescription drug coverage.
What types of Medicare Advantage Plans are available?
There are different types of Medicare Advantage Plans, including Health Maintenance Organization (HMO) plans, Preferred Provider Organization (PPO) plans, Private Fee-for-Service (PFFS) plans, and Special Needs Plans (SNPs). Each type of plan has its own network of doctors, hospitals, and other healthcare providers.
What is the difference between Medicare Part C and Medicare Part A and Part B?
Medicare Part A and Part B, also known as Original Medicare, are provided by the federal government and cover hospital insurance and medical insurance, respectively. Medicare Part C, or Medicare Advantage, is offered by private companies approved by Medicare and provides all the benefits of Original Medicare, as well as additional benefits such as prescription drug coverage.
Who is eligible for Medicare Part C?
To be eligible for Medicare Part C, you must be enrolled in both Medicare Part A and Part B. You must also live in the service area of the Medicare Advantage Plan you wish to join and meet any other eligibility requirements set by the plan.
What does it mean to be "covered by Medicare"?
Being "covered by Medicare" means that you have enrolled in Medicare Part A and Part B, which provide hospital insurance and medical insurance, respectively. It means that you are eligible for the benefits and services provided by Medicare, but it does not necessarily mean that all of your healthcare costs will be fully covered.
How do I get Medicare Part C?
To get Medicare Part C, you need to choose a Medicare Advantage Plan that is available in your area. You can compare different Medicare Advantage Plans and choose the one that best meets your healthcare needs. Once you have selected a plan, you can enroll during the Medicare Advantage Open Enrollment Period or during a Special Enrollment Period if you qualify.
What is the difference between Medicare Advantage and Original Medicare?
The main difference between Medicare Advantage and Original Medicare is that Medicare Advantage Plans are offered by private companies approved by Medicare, while Original Medicare is provided directly by the federal government. Medicare Advantage Plans may offer additional benefits and may have different costs and coverage rules compared to Original Medicare.
What does Medicare Part C cover?
Medicare Part C, or Medicare Advantage, covers all the benefits provided by Medicare Part A and Part B. This includes hospital insurance (Part A), medical insurance (Part B), and in some cases, prescription drug coverage. Medicare Advantage Plans may also offer additional benefits such as dental care, vision care, and wellness programs.
How do I know if I am eligible for Medicare Part C?
To be eligible for Medicare Part C, you must meet the eligibility requirements set by Medicare. This includes being enrolled in both Medicare Part A and Part B, living in the service area of the Medicare Advantage Plan you want to join, and meeting any other requirements specific to the plan. It is recommended to contact Medicare or the specific Medicare Advantage Plan for more information on eligibility.
Can I have both Medicare Advantage and Original Medicare?
No, you cannot have both Medicare Advantage and Original Medicare at the same time. If you choose to join a Medicare Advantage Plan, you will be automatically disenrolled from Original Medicare and will receive all your Medicare-covered healthcare through the Medicare Advantage Plan. However, you can switch back to Original Medicare during certain enrollment periods if you decide to do so.