What Does Medicare Part C Specifically Cover?

November 27, 2024•3 min read

Medicare Part C, also called Medicare Advantage, offers an alternative way to receive your Medicare benefits. It is a comprehensive plan that often includes additional coverage not provided by Original Medicare. At Neuse Consulting Group, located in Wake Forest, North Carolina, we are here to help you understand what this plan covers and how it can benefit you.

What is a Medicare Advantage Plan?

A Medicare Advantage Plan is an insurance plan offered by private insurance companies that are contracted with Medicare. These plans include all the benefits of Original Medicare Part A and Part B, and often additional services. They are designed to provide you with more comprehensive coverage than what is covered by Original Medicare.

Types of Medicare Advantage Plans

Medicare Advantage Plans come in several forms. Each type offers different benefits, so it's important to choose a plan that fits your needs:

Health Maintenance Organization (HMO): Requires choosing a primary care doctor and getting referrals to see specialists.
Preferred Provider Organization (PPO): Offers more flexibility in choosing healthcare providers and doesn't generally require referrals.
Private Fee-for-Service (PFFS): Allows you to see any Medicare-approved doctor or hospital that agrees to the plan's terms.
Special Needs Plans (SNPs): Designed for people with specific diseases or characteristics.

Medicare Part C - What Does It Include?

Medicare Part C plans often include benefits that go beyond what is covered by Original Medicare. Here's what Medicare Part C plans typically cover:

All benefits of Medicare Part A and Medicare Part B
Prescription drug coverage (often called Part D)
Additional benefits such as dental, vision, and hearing

How to Enroll in a Medicare Advantage Plan

To enroll in a Medicare Advantage Plan, you must be eligible for Medicare. This typically means you are 65 or older, or you have certain disabilities. You must first be enrolled in both Medicare Part A and Part B. Once you meet the eligibility criteria, you can choose a Medicare Advantage Plan that best fits your needs.

Medicare Advantage Plans Cost and Coverage

The cost of Medicare Advantage Plans can vary. Here’s what you need to consider:

Premiums: Many Medicare Advantage Plans have low or $0 monthly premiums, but you must continue to pay your Medicare Part B premium.
Deductibles: These plans may have different deductibles compared to Original Medicare.
Out-of-pocket expenses: Medicare Advantage Plans usually have a cap on out-of-pocket expenses, which can help manage healthcare costs.

Choosing the Right Medicare Advantage Plan

Choosing the right Medicare Advantage Plan involves considering your healthcare needs and budget. Here are some factors to keep in mind:

Does the plan cover all the services you need, like dental and vision?
Are your preferred doctors and hospitals in the plan’s network?
What are the costs, including premiums, deductibles, and copayments?

The Difference Between Medicare Advantage and Original Medicare

Original Medicare includes Part A and Part B, but it doesn't cover everything. Here’s how Medicare Advantage differs:

Medicare Advantage Plans are offered by private insurance companies and include additional benefits like dental and vision.
Original Medicare doesn't cover prescription drugs, but many Medicare Advantage Plans do.

Why Choose a Medicare Advantage Plan?

Choosing a Medicare Advantage Plan can provide you with comprehensive coverage that includes additional benefits not found in Original Medicare. These plans offer flexibility, potential cost savings, and broad coverage options. If you need help to choose a Medicare Advantage Plan, Neuse Consulting Group can assist you in making an informed decision.