Medicare Part C

Medicare Part C is used to refer to the Medicare Advantage (MA) Plans. Medicare Approved private health insurance companies operate Medicare Advantage Plans. These companies are then reimbursed through Medicare. There are many different types of Advantage Plans and they are all required by law to provide the same standard of care available through the Original Medicare Plan Part A and Part B. How they are managed, the physicians you can see, the hospitals that are covered, co-payments, deductibles and variety of other variables are different for each Advantage Plan. Like Original Medicare Part B, you will have to pay a monthly premium for MA Plans.

Advantage Plans are unique in that most of them also include prescription drug coverage. Prescription drug coverage is added to Original Medicare using Medigap (supplemental) insurance policies. Some Advantage Plans do not provide coverage for prescription drugs and these plans can be used in conjunction with supplemental prescription drug plans. However, if your Advantage Plan does include drug coverage you can't also use a Medigap policy. Advantage Plans also often cover vision care and dental care that is not covered by Original Medicare.

Choosing the correct Medicare Advantage Plan takes considerable time and energy. Available Advantage Plans should be compared against one another and against Original Medicare. Some of the variables to consider when looking at the Medicare Advantage Plans include:

  • Choice of provider. Most MA plans are PPO's and HMO's and they will limit your choice of providers compared to Original Medicare.
  • Current retiree medical benefits. If you have good retiree health benefits from your previous employment these can usually be used in conjunction with Original Medicare. In most cases these plans can be used as Medigap coverage with Original Medicare. Often they can't be used with Medicare Advantage Plans. If you drop these benefits in favor of a Medicare Advantage Plan you may not be able to recover your retiree benefits.
  • Current health and financial needs. Some retirees have very limited resources and the flexibility of the Advantage Plans can be much more suitable for their situation than Original Medicare.
  • Travel and location. Most MA plans are location specific and may offer limited coverage outside of the immediate provider area.
  • Enrollment times and limits. Medicare Advantage Plans have specific times during the year for enrolling in or changing plans.

Medicare Advantage Plans provide several good alternatives to Original Medicare. The real advantage of these plans is that they can be more flexible and tailored to an individual's needs than Original Medicare. All Advantage Plans are different and it will require careful study to select the most advantageous plan for your situation.

Auntie Lou says, "What is the advantage here? I don't get it."