Medicare Part C



If you qualify for or are already enrolled in Original Medicare, you can choose to enroll in Medicare Part C, more commonly known as Medicare Advantage. Medicare Advantage plans are offered by private health insurance companies and provide Medicare Part A and Part B coverage (hospital and medical benefits).

You might wonder why a beneficiary would choose to enroll in Medicare Advantage. A Medicare Advantage plan generally covers everything that Original Medicare covers, including emergency and urgent care. But, there can be some differences between Original Medicare and Medicare Advantage. Those differences can be in how much you pay out of your own pocket when you receive health care. For example, you might have lower copayments and coinsurance or a smaller deductible.

In general, Medicare Part C coverage includes:

1. A Medicare Advantage Plan is another way to get your Medicare coverage. A Medicare Advantage Plan is a type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits.

2. Medicare Advantage Plans include HMOs, and PPOs. If you are enrolled in a Medicare Advantage Plan, Medicare services are covered through the plan, and aren’t paid for under origina Medicare. Most Medicare Advantage plans also come with a Part D Prescription drug plan included as part of the plan at not extra charge.

3. You can join a Medicare Advantage Plan even if you have a pre-existing condition, except for End-Stage Renal Disease (ERSD). To join a Medicate Advantage Plan you must have Medicare Parts A and B, and you must live in the Plan’s service area.

4. A Medicare Supplement (Medigap) policy is different from a Medicare Advantage Plan. Medicare Advantage Plans are way to get Medicare benefits, while a Medigap policy only supplements your Original Medicare benefits. You have to pay a monthly premium for a Medicare Supplement (Medigap) Insurance policy, and a separate premium for a Part D prescription drug plan.

5. Medicare Supplement (Medigap) insurance, sold by private companies, can help pay some of the health care costs that Original Medicare doesn’t cover, like co-payments, coinsurance, and deductibles.