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What is Part C of Medicare?

Medicare Part C is most commonly referred to as 

Medicare Advantage (MA) plans.

 

MA plans are offered by private insurance companies and work in place of Original Medicare. You usually pay a lower monthly premium amount for these plans, when compared to Medicare Supplement coverage, but you are subject to co-pays/co-insurance when you see your doctor or receive medical services. 

 

MA plans combine your hospital, doctor and prescription drug (usually) coverage all into one plan so you would be using one card at the hospital, doctors office and pharmacy.

These plans work completely different than a "Medicare Supplement". You must choose one or the other. You get to choose whether you want to receive your care directly from "Original Medicare" Parts A and B and adding an optional Medicare Supplement or from a private insurance company offering a Medicare Advantage plan.

It is very important to know that you can't have Medicare Supplement and a Medicare Advantage plan at the same time. You must choose one or the other.

How much do I pay for Part C?

Medicare Advantage plan premiums and co-pays/co-insurance vary from plan to plan. There are some Medicare Advantage plans with zero premium and some others charge a monthly premium to have the coverage. It is important to look at all available plans in your area to determine which will work best for you. While enrolled in a Medicare Advantage plan you must still pay your Medicare Part B premium.

When am I eligible to enroll into a Part C plan?

In order to be eligible for Part C of Medicare:

 

  • You must have both parts A & B of Medicare.

  • You must live in the plans service area.

You can only enroll into these plans at certain times. You can enroll into a plan during your Initial Enrollment Period (when you first get Part B of Medicare). You can also enroll into a plan if you qualify for a Special Enrollment Period in a situation like moving to a new area or losing your employer coverage. Each year you're given an opportunity to change plans as well. This period is known as the Annual Enrollment Period and it runs from October 15th through December 7th of each year. During this time you can compare plans for the following calendar year and make changes for the upcoming year.