What is Medicare Part C
Many people see television ads telling them they need Medicare Part C. In this post we answer the question; What is Medicare Part C and do you actually need it.
Medicare Advantage (Part C), gives Medicare beneficiaries an alternative coverage option to Original Medicare. Medicare A & B provide coverage for essential health care benefits such as; doctor visits and hospitalization. Part C (MA plans) take the place of your Medicare Part A & Part B benefits and are available through private insurance companies. They also provide many value added benefits such as prescription coverage (Part D), dental, hearing, vision, OTC benefits and more.
More details about Part C:
All Medicare Advantage (Part C) plans are offered by private insurance companies. MA/MAPD (Part C) carriers are regulated by CMS and must provide beneficiaries the same level of medical coverage that Original Medicare (A&B) provides.
Most Part C (MA/MAPD) plans offer a very competitive premium, many plans have a $0 premium as well as low out-of-pocket costs. This gives people a very cost effective way to get the healthcare coverage they need.
If you opt for a MA/MAPD (Part C) plan, you should be aware of the plan’s provider network and confirm that your doctors are in-network with your selected plan. Even if you choose a PPO plan, using an out-of-network provider can be a costly mistake.
Each year, during the AEP, you have an opportunity to either enroll in or out of your current Medicare plan. The AEP starts on Oct. 15th and ends on Dec 7th. If you are enrolled in a MA/MAPD, you have an extra opportunity to change your coverage options starting Jan 1 and ending March 31 each year; this is called the OEP.
Summary – Why Choose a Medicare Advantage Plan (Part C):
Part C (MA/MAPD) plans provide comprehensive coverage including additional benefits such as; dental, vision, hearing, prescriptions, OTC, rides to appointments and more. They also cover Medicare A & B charges for doctors and hospitals. Many plans include Part D, prescription drug coverage. All you need is one card to cover your medical costs.
Because MA/MAPD plans have annual out-of-pocket maximums, beneficiaries can feel safe knowing the cost of their annual healthcare has a limit. Plans also offer clear costs for services. Some carriers offer coordination of care benefits which is a great way for all our providers to stay in the loop on your care needs.
There are several different plan options to suit your personal needs including; HMO, PPO, PFFS, DSNP, ISNP, etc.
A Medicare Advantage plan (Part C) is not for everyone:
It is important to consider many factors before choosing Medicare Part C coverage. Some things to think about are; your personal healthcare needs as well as your budget. With careful research and an understanding of the plan’s features, you can make an informed decision that supports your health and well-being.
One of the most important points is to make sure our providers are in-network with the plan you choose.
Consider any medical conditions you may have an dhow often you will require medical attention. It may be a better bet to join a Medicare Supplement and prescription drug plan depending on your personal health needs. There are co-pays, deductibles and out-of-pocket maximums to think about with a Part C plan.
Make sure you are aware of the plans Star Ratings to be sure yo consider a good quality plan.
Remember; plans change every year. Benefits are added and taken away. That is why it is important to work with a knowledgeable, licensed Medicare agent to help you sort out all your plan options during the AEP or OEP enrollment periods.