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Your information is secured & encrypted. Medicare Part C, also known as Medicare Advantage plans, are offered by Medicare-approved private insurance companies that must follow rules set by Medicare. It includes all the coverage of Medicare Parts A and B, and some plans may include additional benefits that are dependent on the area (State/County) you live.
Medicare Part A helps covers hospital inpatient costs if you are admitted to a hospital by a doctor, in addition to hospice care, some at-home care, and some skilled nursing facility care.
Medicare Part B helps covers preventive healthcare, such as yearly doctor visits and tests, cancer screenings, some vaccinations, diabetes supplies, and ambulance and emergency room services.
Medicare Part D covers prescription drugs not covered by Part B, which covers medication that needs to be administered by a doctor (such as injections). Part D covers outpatient prescription drugs, like those picked up at the pharmacy or delivered in the mail.
Most people don't pay a monthly premium for Part A. However, if you don't qualify for Part A, your monthly premium can cost up from $278 or $505 in 2024, depending on how long you or your spouse worked and paid into Medicare taxes. Your deductible for the year is $1,632 in 2024, before Original Medicare begins to pay. (source)
For Part B, the standard monthly in 2024 is $174.70 but may be higher depending on your income. After your deductible is met, you typically pay 20% of the Medicare-approved amount for medical services. (source)
The Part C and Part D plans costs vary depending on your plan and insurance company.
Medicare Advantage (Part C) does not operate in the same way that original Medicare does, but you do need to have Original Medicare Part A and Part B in order to enroll in a Medicare Advantage plan. Medicare Advantage plans, sometimes called "Part C" or "MA Plans", are offered by Medicare-approved private companies that must follow the rules set by Medicare. In addition, Medicare Advantage plans may offer additional coverage not offered by Original Medicare Part A and Part B that fits your healthcare needs. Each Medicare Advantage plan offer different benefits so reviewing options is always a good choice to see what fits your needs. You can enroll in a Medicare Advantage plan by contacting your current Original Medicare provider. Medicare Advantage enrollees must continue to pay the Part B premium alongside the Medicare Advantage plan premium (determined by the insurer). This MA premium varies from one plan to another, and some may have premiums that align with tight budgets. In terms of out-of-pocket costs, Medicare Advantage plans have a yearly limit on your out-of-pocket costs for all Part A and Part B services.
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross Blue Shield, Anthem Blue Cross, Aspire Health Plan, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, GlobalHealth, Health Care Service Corporation, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Premera Blue Cross, Medica Central Health Plan, SCAN Health Plan, Baylor Scott & White Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint
Medicare Advantage covers: Hospital Insurance: short term inpatient care, short-term skilled nursing facility care, limited home healthcare services, and hospice care. Medical Insurance: preventive services, treatment services and equipment, diagnostic services and testing, durable medical equipment, mental health care (inpatient or outpatient). Prescription drugs: Medicare Advantage helps pay for the cost of your medications, but only certain drugs are covered under Part D – check with your provider to see if your medications are covered in a potential Medicare Advantage plan.
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Of the five types of Advantage plans available, you can choose from: Preferred provider organization (PPO): This plan allows you to see in-network and out-of-network healthcare providers. PPOs are networked in a local area and may expand to a bigger region. Private fee-for-service (PFFS): This plan allows you to see Medicare-approved providers as long as they accept the plan’s payment terms and will see you. You can also have access to a network of providers or see doctors who don’t accept the plan’s payment terms (but you may pay more). Health maintenance organization (HMO): This plan requires you to see an in-network provider unless it’s an emergency, and you will also require a referral if you want to see a specialist. Medical savings account (MSA): This plan combines high-deductible insurance plans with a medical savings account that comes in handy for healthcare costs. Special needs plan (SNP): This plan improves the care for Medicare beneficiaries who are eligible for Medicare and Medicaid, require an institutional level of care, or have certain chronic conditions like dementia or diabetes.
Medicare Advantage Plans must provide at least the same coverage as Original Medicare Parts A and B. This means that you will have the services of Original Medicare Parts A and B, no matter which plan you choose. Aside from the minimum coverage, there are other differences between Original Medicare and Medicare Advantage Plans. Where Medicare Advantage plans differ is that they may offer coverage not covered by Original Medicare.
You can enroll for Original Medicare (Part A and Part B) through Medicare.gov. Medicare Advantage plans, Part D plans, and Medigap plans must be purchased through private insurance companies.
Medicare Fall Annual Enrollment for October 15th to December 7th, each year
The cost of your Medicare will depend on which plans you are enrolled in.
You generally pay a monthly premium for your Medicare coverage and a portion of the costs each time you get a covered service. With Original Medicare, there is no yearly limit on what you pay out-of-pocket. This is why many individuals choose Medicare Advantage.
