MAPD Plans 2024 Archives

What does Medicare Part C cover

If you watch TV, I’m sure you have heard about Medicare Part C. Medicare Part C, also known as Medicare Advantage, is an alternative to Original Medicare (Parts A and B). Private insurance companies offer these plans to beneficiaries. In this post, we will answer the question; what does Medicare Part C cover.

Medicare Part C plans must cover all of the services that Original Medicare covers (except for hospice care, which is still covered under Part A), and they may offer additional benefits such as dental, vision, hearing, and prescription drug coverage. While Original Medicare (Parts A and B) offers essential coverage, many beneficiaries opt for additional benefits through Medicare Part C.

Basics of Medicare Part C coverage

Hospital insurance (Part A)

This includes inpatient hospital care, skilled nursing facility care, hospice care, and some home health care.

Medical insurance (Part B)

This includes doctor’s services, outpatient care, preventive services, and some DME (durable medical equipment).

Prescription drug coverage (Part D)

Many Medicare Advantage plans include prescription drug coverage. Part D coverage is not part of Original Medicare. When it is included in a Part C, Medicare advantage plan, it is called an MAPD plan. If it is not included, the plan is called an MA only plan.

Additional benefits

Many Medicare Advantage plans offer additional benefits not covered by Original Medicare, such as routine dental, vision, and hearing care, fitness programs, transportation services, and over-the-counter allowances for certain health-related items.

More Medicare Part C Benefits

Medicare Advantage plans often have annual out-of-pocket maximums. This can limit the amount beneficiaries spend on healthcare services in a given year. Additionally, some plans have low or no cost $0 premiums. This is a way for some fairly healthy beneficiaries to save money compared to the cost of a Medicare supplement and drug plan.

Many Medicare Advantage plans offer coordinated care through provider networks. This means beneficiaries have access to a network of doctors, specialists, and hospitals who work together to manage their healthcare needs. This leads to more integrated and efficient care.

Things to consider

Network Restrictions: Some Medicare Advantage plans have provider networks, meaning beneficiaries may need to see doctors and specialists within the plan’s network to receive full coverage. It’s essential to check if your preferred healthcare providers are in the plan’s network.
Plan Options: Medicare Advantage plans vary in terms of benefits, costs, and coverage options. It’s crucial to research and compare different plans to find the one that best meets your healthcare needs and budget.
Prescription Drug Coverage: If you choose a Medicare Advantage plan that includes prescription drug coverage (Part D), ensure that it covers your specific medications and pharmacies

Click here to learn about the Pros and Cons of MA plans

Medicare Part C (Medicare Advantage) plans, provide beneficiaries comprehensive coverage, additional benefits, and coordinated care, Medicare Advantage plans provide valuable healthcare options for millions of Americans. However, it’s essential to consider your healthcare needs carefully and compare plan options before enrolling in Medicare Part C to ensure you select the right plan choice.