Medicare Part C & Medicare Advantage Plans

Medicare Part C & Medicare Advantage Options in South Florida

Medicare Part C & Medicare Advantage Plans

Medicare Part C (also known as Medicare Advantage Plans) is a private, Medicare-approved health insurance plan designed for individuals registered in both Parts A & B (Original Medicare). It combines coverage for doctor visits, hospital care, and other medical services in one plan.

It’s important to know that you must be enrolled in Medicare Part A & Part B to join, which means you will continue paying the Part B monthly premium and could also have to pay for the Medicare Advantage Plan’s premium as well. Although there could be some out-of-pocket expenses (like coinsurance or copayments for certain services), there are many advantages to Medicare Part C:

  • Costs are less than Original Medicare Plan
  • You may be able to receive additional benefits offered by the plan like coverage for hearing, dental, 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 premiums!
Seniors with Medicare Part C - Medicare Advantage Plans

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What Does Medicare Part C Cover?

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

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

One last important note is that the number one benefit to having 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. We know how complicated the shopping process can be! Call us today so we can help you enroll in the right Medicare Advantage plan that is just right for you!

Medicare Advantage Plans

Medicare Advantage plans usually cover all of the services covered by Original Medicare with additional optional benefits included. Regardless of which Medicare Advantage plan you choose, remember that you are always covered for urgent and emergency care. Most Medicare Advantage plans include prescription medicine coverage, and benefits can differ from year to year, so it’s important to understand how a plan works before enrolling — also another reason why we’re here! We can help you prepare and review your plan annually as well to make sure you understand any changes in coverage and benefits.


Types of Medicare Advantage (Part C) Plans)

PPO (Preferred Provider Organization)

A PPO is the most commonly chosen type of plan.  With a PPO Plan, you have 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. 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 plans usually have added benefits like vision, dental, hearing, etc, and normally include prescription drug coverage.

HMO (Health Maintenance Organization)

HMOs are the second most common plan and it allows you to see doctors and other health professionals who participate specifically in this provider network. If your doctor is already in network, this could be a good option because you would pay less out-of-pocket for in-network doctors. You may ask yourself, “Why would I limit myself 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 you don’t travel often, 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)

A Medical Savings Account may be extremely valuable for certain individuals. Most individuals who choose this plan are normally very healthy as well as 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. However, this plan generally does not include prescription drug coverage.


Hospital Indemnity Plans

There are also Hospital Indemnity plans with riders which are designed to help “fill in the holes” of Medicare Advantage plans. These plans can be extremely valuable to an individual! Normally, if you have an MSA plan, it’s recommended to purchase a Hospital Indemnity Plan along with 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 separate plans like dental, vision, hearing, etc, but most are usually included with the Advantage plans like the ones we talked about above.


Additional Cancer Insurance

Cancer Insurance comes in handy for individuals who are undergoing Chemotherapy and Radiation later in life. Normally, with Medicare Advantage plans, 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 covers things like outpatient therapy and medications.

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