Medicare Part C

Medicare Part C

What is part C?

Medicare Part C is also known as “Medicare Advantage.” Medicare Part C is only offered by private companies with a Medicare contract. If you join Medicare Advantage Plan, the plan will provide you with Part A (hospital insurance) and Part B (medical insurance).

How much does part C cost?

Today, many Medicare benefit plans are eliminating their monthly premiums. In addition to the elimination of premiums, the direct costs of these plans are generally lower than the original direct costs of Medicare (4). There are different direct costs associated with different Medicare Advantage plans, so it is important to do your research. Your direct costs for Medicare Part C depend on (1):

  • If the plan charges a monthly premium.
  • If the plan pays any of your monthly Part B premiums.
  • If the plan has an annual deductible or an additional deductible.
  • Rates for each visit or service (co-payments or coinsurance).
  • The type of health services you need and how often you receive them.
  • If you follow the plan rules, how to use network providers.
  • If you need additional benefits and if there is any cost associated with those benefits.
  • The annual direct cost plan limit for all your medical services.
  • If the plan pays a portion of your Part B premium, also known as a reduction of the Part B premium:
  • The Medicare Part B award is covered for members with double eligibility

Premiums, copayments, coinsurance and deductibles may vary based on the level of assistance received from members with double SNP qualifications.

What does part C cover?

Remember that everything covered by Parts A and B is covered by the Medicare Advantage Plan. If you are covered by a Medicare Advantage plans, you will be covered for all necessary medical services, including emergency and urgent care. Private companies that offer Medicare Part C generally have medical networks, and this may mean that you should see your plan doctors to get care. When making a decision about Medicare Part C, it is a good idea to ask if doctors near your home are included in your network.

With the exception of hospice care, Medicare Advantage plans are required to cover all services that Original Medicare covers. Original Medicare covers hospice care, even if you are enrolled in Medicare Part C. Medicare Advantage Plans are not supplemental coverage.

When can you apply for a Medicare Advantage plan?

Each year, there is a specific time when you can apply for a Medicare benefit plan called Annual Election Period. Prepare your daily calendar and Google Calendar. The 2012 Annual Election Period is scheduled from October 15 to December 7, 2011. With the exception of beneficiaries who qualify for an Initial Entry Period or Special Income Period, this is the period that applies to you. The deadline for the Annual Election Period is subject to change from year to year, so check for updates!