Summary: Show Medicare Part C — also known as Medicare Advantage — covers everything Original Medicare does, plus a few extra benefits. But these plans also come with some restrictions. We break down the basics so you can choose a Medicare plan that fits your needs. When you’re new to the world of Medicare, you might feel like you’re swimming in a giant bowl of alphabet soup. There are Parts A and B for Original Medicare. There’s Part D for prescription drugs. And there’s Part C, which is also known as Medicare Advantage. “Medicare Advantage is basically a private Medicare,” says Caitlin Donovan, a spokesperson for the National Patient Advocate Foundation. “It’s regulated by the government but run by insurers.” But that’s just the first important fact to know. Here, we tackle your top questions about Part C plans so you can find the health insurance that best fits your life. What does Medicare Part C cover?Think of Medicare Advantage as “bundled” plans: They include everything Original Medicare does and often more, such as coverage for prescription drugs, as well as vision, hearing and dental care. Some even include fitness benefits. What is Medicare Part C coverage for inpatient care?Inpatient care — meaning you’ve been admitted to a hospital — is traditionally covered by Medicare Part A. But if you opt for Medicare Part C, you still get all the coverage of Part A, including:
One important difference to know: Your out-of-pocket costs will vary for each type of plan. eHealth is here to make Medicare easy. Find plans that cover your doctors, medications, and more. What is Medicare Part C coverage for outpatient care?Outpatient care — meaning emergency or observational services, lab tests, or X-rays — is traditionally covered by Medicare Part B. But if you opt for Medicare Part C, you’ll get all the coverage of Part B, including:
If you have Medicare Part C, you may have different copayments, coinsurance, and deductibles than you would with Original Medicare. Original Medicare doesn’t offer drug coverage — which differs from Medicare Part C. “You can choose a Medicare Advantage plan that comes with a drug benefit so you don’t have to pick up a separate Part D plan,” says Donovan. The approved drugs will be listed in the plan you select, so be sure to confirm that your medications are covered before you enroll. (We make comparing plans easy. Try our tool now.) Medicare Part C may offer other perks too, such as:
Keep in mind, though, that not all Medicare Part C plans cover extra benefits in the same way. For example, some Medicare Part C plans might only cover “Medicare-covered dental benefits” — meaning dental care that’s needed for an accident or a disease of the jaw. If your Medicare Part C covers dental benefits more extensively, you may have a higher monthly premium for that coverage. How does Medicare Part C compare to Original Medicare? Medicare Part C and Original Medicare have different costs and different rules regarding coverage for providers, services, and drug plans. Here’s how the two plans can differ: What should I do if my Medicare Part C plan doesn’t cover something I need?If you’re denied coverage for something you need, the first thing you may be able to do is file an appeal. You can appeal for a health care service, supply, item, or prescription drug that you think you should be able to get or that you already got. You also can appeal to pay less than you originally were requested to pay. If your appeal is denied or if you have other frustrations with your plan, you can switch Medicare Advantage plans during the Medicare Open Enrollment Period, which is October 15 to December 7 every year or during the Medicare Advantage Open Enrollment Period, which is January 1 to March 31 each year. Ready to compare Medicare Advantage plans near you? Find a plan that fits your budget and covers your doctor and prescriptions now. The product and service descriptions, if any, provided on these eHealth web pages are not intended to constitute offers to sell or solicitations in connection with any product or service. All products are not available in all areas and are subject to applicable laws, rules, and regulations. |