Getting to Know Medicare Part C

Medicare Benefits Solutions
Nov 23, 2019

When you are eligible for Medicare, you can choose to get your Part A and Part B benefits through Original Medicare or Part C, also known as Medicare Advantage. Medicare Advantage (MA) plans are offered by private insurance companies approved by Medicare to provide Part A and Part B coverage, but many people choose to enroll in a MA plan because many offer additional coverage at little to no additional cost.

Medicare Advantage (MA) plans can offer a wide range of additional benefits, but many of the most popular benefits include routine dental care, vision care, fitness club memberships, hearing exams, and/or prescription drug coverage. Medicare Advantage plans also offer an annual out-of-pocket maximum, which puts a cap on the amount of money you will have to pay each year for medical care. This can protect you in the case of a significant medical event. For instance, if you have to undergo surgery or care for a chronic illness, your out-of-pocket costs can certainly add up. If you have Original Medicare, you’ll be responsible for 20% of the Medicare approved amount. Depending on the cost of your surgery or care, you could be facing stressful medical bills. Many Medicare recipients feel more comfortable knowing there is a limit to what they have to pay.

Medicare Advantage Options

Medicare Advantage plans can include the following types of coverage:

• Health Maintenance Organizations (HMOs)
• Preferred Provider Organizations (PPOs)
• Private Fee-for-Service Plans
• Special Needs Plans
• Medicare Medical Savings Account Plans

Once you choose and enroll in a plan, you usually cannot make changes to your coverage until the Annual Enrollment Period, from October 15 through December 7, unless you qualify for a Special Enrollment Period at another time.

The Medicare Advantage Open Enrollment Period, from January 1 through March 31, gives you the opportunity to switch from one Medicare Advantage plan (with or without prescription drug coverage) to another. You can also drop your Medicare Advantage plan and return to Original Medicare. If you revert to Original Medicare, you can enroll in a Prescription Drug Plan at this time.