Part C is also called “Medicare Advantage” which is an optional form of coverage where you get all of your Medicare Part A and B coverage, and usually your Part D coverage in one place. Medicare Advantage Plans are different in each state and sometimes differ in counties, so it is important to make sure you are looking at plans in your service area.
Part C is not a part of Original Medicare (A & B), so you do not enroll in a Medicare Advantage plan through the Social Security Administration. These are some of the many plans I can assist you with reviewing, once you are enrolled in Medicare Parts A and B.
Medicare Advantage plans are offered by private insurance companies but still have to follow standards and be approved by Medicare each year. You must be enrolled in both Part A and Part B to join a Medicare Advantage plan. You’ll still be in the Medicare program, but you will receive all of your benefits through the Medicare Advantage plan instead of through Original Medicare (your red, white, and blue card).
Medicare Advantage (Part C) Many plans also provide additional benefits.
In same cases, you will need to use doctors and facilities who participate in the plan’s network and service area with a Medicare Advantage Plan. Other plans give you the ability to use out of network doctors and facilities, usually with a higher copay or coinsurance. Common types of Medicare Advantage Plans are HMOS and PPOS.
Advantage plans were built with an out-of-pocket maximum on your yearly medical spending. Think of this as a protection from unexpected and catastrophic medical bills. If you reach this certain out-of-pocket spending, the plan pays for your covered medical expenses for the remainder of the calendar year. Up under you reach the yearly out-of-pocket, you may have copays and co-insurance for covered services. Please note that Part D prescription costs are separate and explained here.
A Health Maintenance Organization is a type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO. Generally you cannot go out of network unless its an emergency.
A Preferred Provider Organization is a type of health plan that contracts with medical providers, such as hospitals and doctors, to create a network of participating providers. You pay less if you use providers that belong to the plan’s network. You can use doctors, hospitals, and providers outside of the network for an additional cost.