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What is Medicare Part C?

Medicare Part C plans, also known as Medicare Advantage Plans, are bundled, all-in-one alternatives to Original Medicare (Medicare Parts A and B). These plans are required to cover all of the same supplies and services as Medicare Parts A and B with the exception of hospice care. Emergency and urgent care, even that received outside the plan’s typical service area, are covered under all Medicare Part C plans. Some Medicare Advantage Plans also cover medication, and many offer additional benefits such as eyeglasses, hearing and dental coverage, and wellness programs. Several different types of Medicare Advantage Plan are available, including HMOs, PPOs, PFFSs, SNPs, HMOPOSs, and MSAs. Please see our other articles to learn more about the specific types of Medicare Advantage Plans that are available.

Costs

Unlike Original Medicare, Medicare Advantage Plans are sold by Medicare-approved private insurers. If you have a Medicare Advantage Plan, you will typically pay two monthly premiums – one for your Medicare Part B coverage specifically and one for the rest of the plan. You may also owe copayments or coinsurance on covered services. Another thing that sets Medicare Part C apart from Original Medicare is that these plans have a yearly limit on out-of-pocket costs. Once this limit has been reached, the plan will pay 100% of covered costs for the remainder of the year. The size of this limit and other specifics pertaining to cost will vary from one plan to another, so be sure to compare multiple plans before you buy.

Eligibility

To purchase a Medicare Advantage Plan, you will need to live within the plan’s service area and already be enrolled in Medicare Parts A and B. There are other restrictions, too – for example, those with End-Stage Renal Disease (permanent kidney failure) are typically ineligible for Medicare Part C. Medicare Supplement Insurance (Medigap) policies will not work with Medicare Advantage Plans. If you already have one of these policies and want to enroll in Medicare Part C, you should consider dropping the Medigap coverage.

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What is covered under Medicare Part C?

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