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Exclusive Benefits
  • Coverage
    Part C provides coverage through private health insurance companies that are approved to participate in the Medicare program. Part C includes all Part A and B services, along with additional services such as wellness programs, hearing aids, and vision services. Medicare Advantage Plans can be HMOs, PPOs, Regional PPOs or Private Fee-for-Service plans.
  • Eligibility
    Let’s take a look at the eligibility criteria for Medicare Advantage Plans. You can enroll for Medicare Part C if you are either:
    • 65 years of age or older.
    • Terminally ill with certain diseases, such as kidney failure.
    • Younger than 65 years, but have certain disabilities.
  • Limitations
    The only limitation for Medicare Part C is that these plans have a defined geographic service area. Most of them have networks of physicians and hospitals where you can receive care. It’s always wise to speak with your physician and check if they participate in your health insurance plan’s Medicare Advantage network.
  • Considerations
    Here are a few points to consider regarding Part C coverage:
    • Medicare Advantage plans, like PPO and HMO plans, usually include prescription drug coverage as well.
    • Your annual costs might vary depending on copays, coinsurance, premiums, and benefits of the plan that you have chosen.
    • Medicare Part C may have copays or cost sharing amounts on services covered by Medicare that differ from the cost sharing amounts in Original Medicare.
    • Every year, Medicare Advantage plans may change their monthly premiums and benefits. This also occurs in Original Medicare, as Part B premiums, standard deductibles, and cost sharing amounts generally change on January 1 each year.
Costs Information

Premium

All Medicare Part C plans require that you continue paying your Part B insurance premium. You might also have to pay a separate monthly insurance premium for your Medicare Advantage plan.

Copay

May apply to certain specific services, such as doctor office visits.

Deductibles

Certain plans have deductibles.

Coinsurance

Cost sharing amounts might apply to specific services.

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