Medicare Part C: An Overview

November 4, 2016

What is Medicare Part C?

Medicare Advantage Plan, also called Part C, is a combination of Original Medicare (Part A and Part B) and various additional benefits depending on the type of advantage plan.  Private companies contracted with Medicare sell these plans.

What does Part C cover?

Advantage plans cover all Original Medicare services including hospital stays, home healthcare, skilled nursing facilities, Part A benefits except hospice care, doctor’s visit, outpatient care, lab tests, and all benefits of Part B.  Additional coverage for vision, dental, hearing and prescription drugs may be included in Advantage plans.  If prescription drug coverage is not included in your plan, you will have to buy it separately as Part D.

What does Part C not cover?

Part C does not cover hospice care, but hospice care will be provided through Original Medicare. Not all Advantage plans will include prescription drug coverage. If your plan does not, you will need to enroll in a prescription drug plan (Part D) for prescription drug coverage.  You cannot have a prescription drug plan and drug coverage through Part C.  If you enroll for Part D while having prescription drug coverage through Part C, you will automatically be disenrolled from Part C.

What does Part C cost?

The costs of a Medicare Advantage Plan can vary from plan to plan depending on a number of factors.  In general, the costs can be broken down as cost of Part A and Part B, which means you must pay the standard Part B premium, deductible, and coinsurance; and the premium for Part C.  The premium for Part C is dependent upon the extra benefits you receive in the Advantage plan.  These can include prescription drug coverage, vision and dental coverage, wellness programs and hearing care.

When to enroll in Part C?

You must be enrolled in Original Medicare to enroll in Part C.  You can enroll in an Advantage plan during the Medicare Initial Eligibility Period as well as the Open Enrollment Period.

Sources:

https://www.medicare.gov/sign-up-change-plans/medicare-health-plans/medicare-advantage-plans/how-medicare-advantage-plans-work.html

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