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What is Medicare Part C?

Ensuring that your Medicare plan provides you the best coverage possible is of the utmost importance. That’s why we are here to inform you about additional coverage you can receive through Medicare Part C.

Also known as Medicare Advantage, Medicare Part C is an insurance policy that serves as an alternative to a traditional Medicare Plan. It provides the same coverage as Medicare Parts A and B, but may include added benefits like vision, dental, hearing, and other coverage benefits. Medicare Part C is provided by private insurance companies, so the amount of coverage varies widely across the board. You are eligible for Medicare Part C if you already have Medicare Parts A and B. Health Maintenance Organization (HMO) plans, Preferred Provider Organization (PPO) plans, Private Fee-For-Service (PFFS) plans, Special Needs Plans (SNP) and Medicare Medical Savings Account (MSA) plans are all different types of Medicare Part C coverage.

We are here to break down Medicare Part C in order to help you decide if it would be beneficial for you to enroll.

What does Medicare Part C cover?

Medicare Part C covers more than what traditional Medicare covers. Things like prescription drugs, dental care, vision care and hearing care along with hospital and medical costs may be covered by Medicare Part C. Some insurance companies even offer gym memberships (Silver Sneakers) or transportation coverage as part of their Medicare Part C plan.

Because Medicare Part C is provided by private insurance companies, there can be a lot of variation in what plans offer. For instance, some may provide more extensive dental coverage while others may be more limited in vision coverage. Medicare Part C plans also come in a variety of structures (HMOs, PPOs, PFFS, SNP and MSA plans) that give customers a wide variety of coverage options. Although they offer differing coverage amounts, most cover dental, vision and hearing care along with prescription drugs. It is important to fully understand exactly how much coverage your Medicare Part C plan offers. Doing research and comparing plans is the best way to figure out which Medicare Part C plan is right for you.

Types of Medicare Part C Plans

There are several different types of Medicare Part C plans that provide different levels of coverage at different price points. Here’s a breakdown of the different plans:

Health Maintenance Organization (HMO)

These plans provide networks of care providers that you have access to under the insurance plan. If your doctor is listed on an HMO plan, you can save loads of money by enrolling in the plan.

Preferred Provider Organization (PPO)

PPO offer more flexibility. PPOs cover doctors both in and out of the network. As long as the doctor accepts traditional Medicare, it will be covered.

Private Fee-for-Service (PFFS) plans create payment terms which doctors must accept before treating you. If the doctor doesn’t agree, then the services will not be covered by insurance.

Special Needs Plans (SNP)

SNP offer more coverage for those with special circumstances, like HIV/AIDS, mental disabilities or diabetes. Special Needs Plans are either CSNP or DNSP. CSNP plans are typically for people with Chronic conditions requiring special care such as Diabetes or Heart issues. DSNP plans are for people who meet certain low income requirements and can coordinate benefits with their state’s Medicaid plan.

Medical Savings Account (MSA) plans have high deductibles that you can pay with the bank account given to you to help you pay for qualified healthcare expenditures.

Understanding the differences between the types of plans can help you decide which one fits your health circumstances and meets your needs.

Do I need Medicare Part C?

You may benefit from Medicare Part C if you are interested in prescription drug coverage or dental, vision or hearing coverage. Most Medicare Part C plans conveniently provide coverage for all of these things. If you use any of these services regularly, a Medicare Part C plan may be worth it. It could help you save money and could give you access to more services. It may also be beneficial to you if your doctors are on a plan’s network. If your doctor is listed on the Medicare Part C Plan’s network, then all expenses will be covered by Medicare Part C. It is only if you use care providers outside of the plan’s network that you will have to pay for it.

As previously mentioned, if you already have Medicare Part A and Medicare Part B then you are eligible for Medicare Part C. In general, if you are looking for additional coverage by your healthcare plan, it may be worth it for you to consider enrolling in a Medicare Part C plan. Medicare Part C provides coverage for traditional Medicare expenses plus dental, vision, hearing and prescription drug coverage all in one convenient plan.

How much does Medicare Part C cost?

Because Medicare Part C plans vary widely, the premiums and prices vary as well. Medicare Part C costs are determined by where you live, your health conditions and the amount of coverage you are looking for, and your financial situation. A Medicare Part C plan that provides more extensive coverage will definitely be more expensive than one that provides less coverage. You may be surprised to hear that many Medicare Part C plans have a $0 monthly premium.

It is important to consider the maximum out-of-pocket expense that is set for your Medicare Part C plan. Depending on the extent of added coverage, Part C plans can have a maximum out-of-pocket expense of up to $10,000. This means that once you reach this out-of-pocket limit, the plan will pay the remainder of your healthcare expenses for the rest of the year. Be sure to consider both premiums and out-of-pocket expenses for each Medicare Part C plan. This is an area where you may want to consider differences Medicare Part C vs Medicare Supplement plans.

Some HMO plans save people more money than a PPO would. It all depends on your medical situation and what you need covered. The plan that works for someone else may not work for you. That is why it is important to research different Medicare Part C plans for which you are eligible in order to decide which plan is the best for you.

Be sure to do some research on all the different Medicare Part C plans on the market and make sure to understand the Medicare Enrollment Periods. Some may offer additional aid that would benefit you and could even save you money. Examine your own healthcare needs and financial circumstance when considering a Medicare Part C plan. If you have questions about which plans you qualify for contact us today for a free call.

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