What is Medicare Part C
Medicare Advantage Plans are health plan options similar to HMOs and PPOs approved by Medicare. They are a part of the Medicare program but run by private insurance companies. Sometimes you will hear them referred to as “Part C” or “MA plans.” Medicare pays an amount for your care every month to these private health plans. Medicare Advantage Plans must follow rules set by Medicare.
What Coverage is Provided?
Medicare Advantage plans provide all of both Part A (hospital insurance) and Part B (medical insurance) benefits and must cover at least all of the medically-necessary services that the original Medicare plan provides. However, Medicare Advantage plans can charge different copayments, deductibles and coinsurance for services. It is important to research any plan before enrolling to find out the cost of services and to verify whether the plan meets your needs.
Medicare Advantage plans may offer benefits including vision, hearing, dental, health and prescription drug coverage. Most Medicare Advantage plans have provider networks, meaning you would have to see a doctor or go to hospital that belongs to the plan. You may also need a referral.
Some plans may allow you to use out-of-network providers at times for a higher cost. However, using providers who are not in the network may leave you vulnerable to being charged the entire cost of the covered service. You should ask your doctor or hospital whether they accept the plan before receiving services.
* Please note that Medicare Advantage Plans are not treated as supplemental insurance.