Medicare Part C
At this point, you have signed up for Original Medicare (Parts A & B) and learned that not everything is covered in Parts A & B. With no limit or cap, you will owe 20% for each bill.
There are two plan options to help cover where Medicare A & B fall short of coverage. These are Medicare Advantage Part C and Medicare Supplement Insurance, which you only need one of these. For now, let’s focus on Medicare Advantage Part C here.
About Medicare Advantage Plans (Part C)
Medicare Advantage plans are offered by federally contracted private insurance companies.To help cover medications, these plans combine Part A, B and D.
Most Medicare Advantage Plans include Part D coverage and are called MAPD. If they don’t include Part D, then they are called MA Plans.
Whether you have HMO or PPO, you will want to use in-network providers as much as possible with most Medicare Part C plans. With these two types, let’s briefly cover the differences.
HMO
- Must select a primary care physician to coordinate care
- Out-of-network care is not covered unless urgent or an emergency
PPO
- Won't need to select a primary care physician, and you can access physicians out of the network
- Your out-of-pocket costs will be higher if you choose out-of-network care
Who is eligible for Medicare Part C?
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You must be entitled to Part A & enrolled in Part B
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You must live in the plan's service area
What does Medicare Part C cover?
Unlike Medicare Supplement Insurance Plans, coverage depends on the specific plan because Medicare Advantage Plans are not standardized. We will work with you and show you all the Part C plans in your area. Generally, it could offer added benefits in addition to the core benefits of Part A & B that Medicare doesn’t cover.
Medicare Advantage coverage adds another layer to securely enjoying your later years.
Keep reading as we have merely scraped the surface of possible questions you may have. Please reach out to get answers to other questions that you may have so we can ensure you have the right answers before you make the ultimate decision.
Click each link to learn about the other parts of Medicare:
FAQ
Medicare Advantage Plans have a Maximum Out-of-Pocket limit and may include additional benefits that are not covered by Original Medicare.
In addition to drug coverage, general wellness and health management are also enhanced. As we mentioned before, out-of-pocket expenses decrease under the umbrella of covered services.
Ultimately the choice is yours. Maybe you're still on the fence about its feasibility in your case.
We're happy to provide more detail to ensure that you make the best decision for your lifestyle. Give us a call at 510-868-9160 today!
Many people find that their out-of-pocket expenses are less than with Original Medicare. With the additional coverage, it can be a solid choice for those seeking more value.
Your monthly premiums will depend on the particular plan, as do:
- Coinsurance
- Copays
- Deductibles
And now, one final tidbit that may factor into your choice. Once you meet the yearly limit on out-of-pocket costs, your medical services are covered at 100% (network limitations may apply depending on plan type).
When you turn 65 and have enrolled in Medicare A & B, you are eligible to enroll in any Medicare Advantage plan offered in your local area. Or, if you’re leaving your Employer Group coverage, you’ll have a Special Election Period to enroll in a Medicare Advantage Plan.”
After that, the annual enrollment period is from October 15th to December 7th. During this time, you can enroll in a Medicare Advantage, drop your current Medicare Advantage, enroll in Original Medicare, and add a Medicare Supplement Insurance plan. Changes will be effective January 1st.
We'll help you find the Medicare Advantage that fits your unique situation.
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