Part C - Medicare Advantage

Not everyone needs Part C because not everyone wants to have a Medicare Advantage plan.

What is a Medicare Advantage plan?

A Medicare Advantage plan are plans offered by private insurance companies as an alternative to Original Medicare. These plans bundle the Part A, Part B and usually Part D coverage as well as offer other benefits not normally covered by Original Medicare.

What are the costs to a Medicare Advantage plan?

While these plans cover what Original Medicare will cover, to join a Medicare Advantage plan you must continue to pay your Part B premium. Premiums can be as low as $0 and you would pay the stated copay or coinsurance outline on the plan’s Summary of Benefits after any deductibles.

What are the different kinds of Medicare Advantage plans are there?

PPO - Preferred Provider Organization: This allows for in- and out-of-network providers to be used with no referral needed to see a specialist. Seeing in-network providers and facilities will have a lower out-of-pocket costs compared to going out-of-network.

HMO - Health Maintenance Organization: This means all your health providers, hospitals and other health related facilities covered by then plan must be within one medical group. To see a specialist you would need to see your primary care provider first and confirming authorization first.

HMO-POS: Health Maintenance Organization with a Point of Service: The same as an HMO, but may get out-of-network care for certain services such as dental. You still need a referral for a specialist.