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Medicare Part C is an alternative name for Medicare Advantage. Medicare Part C is another way to get your Medicare Part A and Part B benefits from a private insurance company. According to the National Institutes of Health (NIH) Medicare Part C gives Medicare beneficiaries a choice of health insurance plans. Medicare Part C also transfers the efficiencies and cost savings of managed care in the private sector to Medicare beneficiaries. Medicare Part C is still regulated by the federal government.
Medicare Advantage plans must cover everything that Original Medicare (Part A and Part B) cover. This generally includes:
If you have Medicare Part C, hospice care is still covered by Medicare Part A.
Medicare Part C may also cover additional services that Original Medicare generally doesn’t cover such as:
Coverage of supplemental benefits may vary from plan to plan. For example, some Medicare Part C plans may pay $1,000 every three years for hearing aids and some plans may not cover hearing aids.
Each Medicare Advantage plan with prescription drug coverage has its own formulary, which is a list of covered prescription drugs. Check the formulary to make sure that your particular prescription drugs are covered. The formulary may change at any time but you will receive notice from your plan when necessary.
Parts of Medicare include Medicare Part A (hospital insurance), Medicare Part B (medical insurance) and Medicare Part D (prescription drug coverage). Most Medicare Part C plans already include the benefits of Medicare Part A, Part B, and Part D so Medicare Part C should be all the coverage you need.
Another type of Medicare plan is called Medicare Supplement (Medigap). Medicare Supplement plans cover Medicare out-of-pocket costs including copayments, coinsurance, and deductibles. A Medicare Supplement plan cannot be used together with a Medicare Part C plan.
The cost of a Medicare Part C plan can vary from plan to plan. Some costs you may pay include:
All Medicare Part C plans have an annual out-of-pocket maximum. This is a set amount, for example, $5,000, that you pay and then all of your covered medical expenses are paid for by the plan. Original Medicare has no out-of-pocket maximum.
To qualify for Medicare Part C you must:
To qualify for Medicare Part A and Part B you must be
You may be able to qualify for Medicare Part C Special Needs Plan if you have ESRD.
You can enroll in Medicare Part C during your initial enrollment period. This is a 7 month period that begins three months before you turn 65, includes the month you turn 65, and ends three months after the month you turn 65. If you miss your initial enrollment period, you can still enroll in Medicare Part C during Medicare Open Enrollment each year. Open Enrollment is from October 15-December 7.
Do you want to start shopping for Medicare Part C today? Just enter your zip code on this page to start comparing plans in your area.
eHealth's Medicare website is operated by eHealthInsurance Services, Inc., a licensed health insurance agency doing business as eHealth. The purpose of this site is the solicitation of insurance. Contact may be made by an insurance agent/producer or insurance company. eHealth and Medicare supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. We offer plans from a number of insurance companies.