More About Medicare Part C or Medicare Advantage Plans

Although there could be some out of pocket costs (like coinsurance or copayments for certain services), there are many advantages to covered services of Medicare Part C:

• Medicare Part C Costs are less than Original Medicare Part A and Original Medicare Part B Plan

• You may be able to receive extra benefits offered by the plan like coverage for doctor visits, hearing, dental services or routine dental care, vision, special discounts on certain health-related products and wellness programs

• You could be eligible for subsidies to help pay your prescription drug coverage and monthly premium!

What Does Medicare Part C Cover?

Medicare Part C covers all of the services of Medicare Part A and Medicare Part B, which means you will have both outpatient medical insurance and hospital insurance. However, rather than paying deductibles and 20% (coinsurance) of your medical insurance, you will only be paying the plan’s copays. 

Remember that every penny you spend on Medicare Part A and Medicare Part B medical services is contributed towards your out of pocket costs maximum. When you hit that out of pocket costs maximum, your Medicare Part C will pay 100% for the remaining year. Medicare Part C coverage also usually comes with a built-in Medicare Part D prescription drug coverage.

One last important note is the primary benefit to a Medicare Advantage plan is a lower cost option to having a maximum out of pocket on your Medicare coverage.

All Medicare Advantage plans have different rules, networks, and enrollment periods. Call us today so we can help you enroll in the right Medicare Advantage plan that is just right for you!

How Medicare Advantage Plans Work

Medicare Advantage plans should cover all of the Medicare coverage services covered by Original Medicare with additional benefits included. Regardless of which Medicare Advantage plan you choose, know that you are always covered for urgent and emergency care, as well as Medicare coverage like dental benefits, routine dental care, prescription drug coverage. A majority of medicare Advantage plans include prescription drug coverage, and the extra benefits can change year to year, so it’s important to understand how a Medicare Advantage Plan works before enrolling — also another reason why we’re here! We can help you prepare and review your plan annually as well to ensure you understand any changes in coverage and benefits.

Types of Medicare Advantage Plans (Medicare Part C)

PPO (Preferred Provider Organizations)

This is probably the most common type of Medicare plan. With a PPO Plan from private insurers, you have services covered reduced cost-sharing when you use a Preferred Provider or member of the PPO network, but you’re not required to use a PPO provider to receive medical services like routine dental care, drug coverage, and extra benefits like inpatient hospital stays. This plan covers both in-and out-of-network providers, which gives you the freedom to choose any doctor that accepts your Medicare plan. It’s a great choice if you are looking for flexibility. PPO plan usually have added benefits like vision, dental, hearing, etc, and normally include prescription drug coverage.

Medicare Advantage HMO (Health Maintenance Organizations)

A Medicare Advantage HMO plan is the second most common plan allows you to see doctors and other health professionals who participate in this provider network. If your doctor is already in network, a Medicare Advantage HMO plan may be a good option because you would pay less out-of-pocket for in-network doctors for the same benefits like dental benefits while you save money. A good question to ask yourself is, “why would I limit myself on Medicare Coverage to an HMO when a PPO is available?” Well, if you’re using a small knit group of doctors and hospitals already in the HMO network and your don’t travel that much, your HMO plan would typically have much lower copays, deductibles, coinsurance, and other cost-sharing benefits, along with prescription drug coverage.

MSA (Medical Savings Account)

This type of supplemental coverage plan could prove to be extremely valuable for certain individuals. Most people who would choose this plan are normally very healthy and financially stable. Medical Savings Account plans include both a high deductible health plan with an annual deposit that can build up an account value that will help pay for that deductible and provide someone with 100% coverage. The amount deposited into the account varies from plan to plan and the money is tax-free as long as you use it on IRS-qualified medical expenses, like your health plan’s deductible. MSA’s also have the added benefit of having $0 premiums, and are accepted by all providers who accept Traditional Medicare. It’s important to note, however, that this plan generally does not include prescription drug coverage.

Hospital Indemnity Plans

There are also Hospital Indemnity plans with riders that are designed to help “fill in the holes” of Medicare Advantage plans, and these plans can prove to be extremely valuable! Usually, if you have an MSA plan, it’s recommended to purchase a Hospital Indemnity Plan as well as a lump sum cancer rider until the account value on the MSA plan reaches a level that doesn’t require a HIP plan and then like magic, it’s gone! 

Separate Plans

With Medicare Advantage, you can purchase plans like dental, vision, hearing, etc, separately, but most are usually included with the Advantage plans we talked about above.

Additional Cancer Insurance

Unfortunately, Cancer Insurance comes in handy for individuals who are undergoing Chemotherapy and Radiation later in life. Medicare Advantage plans usually have you pay 20% of your outpatient Chemo or Radiation until you meet your maximum out-of-pocket, along with high-priced cancer medication, which can be extremely expensive. Cancer Insurance helps fill in the holes of Medicare Advantage and can cover drugs and things like outpatient therapy and medications.