Medicare Part C

What is Medicare Part C?

Medicare Part C is a type of Medicare health plan offered by private insurance companies that have been approved by Medicare. Medicare Advantage plans must offer the same coverage as Original Medicare (Parts A and B) but can also include additional benefits, such as vision, dental, and wellness programs. Unlike Original Medicare, which is a federal program, Medicare Advantage plans are offered through private insurance companies.

How does Medicare Advantage (Part C) differ from Original Medicare?

One of the main differences between Medicare Advantage and Original Medicare is that Medicare Advantage plans are offered through private insurance companies. These plans must offer the same coverage as Original Medicare but can also include additional benefits and services not included in Original Medicare, such as prescription drug coverage, vision, dental, and hearing. Another significant difference is that Original Medicare is fee-for-service, while Medicare Advantage plans are usually network-based. This means that Original Medicare will pay for any healthcare provider that accepts Medicare, while Medicare Advantage plans often have a network of healthcare providers that members can use.

What are the benefits and coverage options offered by Medicare Part C plans?

Medicare Advantage plans often offer more benefits than Original Medicare alone. Some of the benefits and services that Medicare Advantage plans may offer include:

• Prescription drug coverage: Many Medicare Advantage plans offer prescription drug coverage through Medicare Part D.
• Vision, dental, and hearing coverage: Some Medicare Advantage plans offer coverage for vision, dental, and hearing services that aren't covered under Original Medicare.
• Wellness programs: Many Medicare Advantage plans offer wellness programs, including gym memberships, health coaching, and other services to help members stay healthy.
• Comprehensive coverage: Medicare Advantage plans can offer comprehensive coverage, including hospital coverage, physician services, and other benefits.
• Maximum out-of-pocket costs: Medicare Advantage plans often have a maximum out-of-pocket spending limit, which can help protect members from financial hardship due to serious illness or injury.
• Flexibility: Unlike Original Medicare, which does not offer any flexibility when it comes to coverage, Medicare Advantage plans can come in different forms offering different benefit levels with different premiums, networks, and other parameters.

Are prescription drugs covered under Medicare Part C plans?

Medicare Advantage plans must offer the same coverage as Original Medicare, which includes prescription drug coverage under Part D. However, not all Medicare Advantage plans include prescription drug coverage. To determine what your Medicare Advantage plan covers, review the plan's Evidence of Coverage document, which outlines the plan's benefits, costs, rules, and restrictions.