Medicare Part C

Medicare Part C, also known as Medicare Advantage (MA), is one of your options as you consider how to get your Medicare benefits. When you qualify for Medicare, you can get your Part A and Part B coverage through Original Medicare or through a Medicare Advantage plan. Original Medicare is administered by the federal government, but Medicare Advantage plans are offered by private insurance companies who contract with Medicare to provide your benefits.

MA plans are required to include at least the same coverage as Original Medicare Part A and Part B, but most plans will include additional insurance coverage. Because they are offered by private companies, costs and coverage can vary between Medicare Advantage plans.

What benefits could be included in a Medicare Advantage (MA) plan?

As mentioned, MA plans will include Part A (hospital insurance) and Part B (medical insurance) benefits, but many plans include a wide range of extra benefits that may include:

  • Prescription drug coverage
  • Vision care, including glasses and contacts
  • Routine dental care
  • Hearing exams and coverage for hearing aids
  • Fitness programs and gym memberships
  • Over-the counter allowances
  • And more

Plans vary, so it’s important to compare plans available in your area before enrolling. The idea of having a single plan that meets your comprehensive insurance needs appeals to many Medicare recipients.

Will a Medicare Advantage plan help lower my healthcare costs?

Medicare Advantage plans may help lower your overall medical costs. Many plans offer additional benefits above and beyond Part A and Part B with little to no additional cost to you. MA plans also have an annual out-of-pocket maximum limit. This means that once you’ve reached that limit, you will pay nothing for the remainder of the year for any covered medical expenses you may incur. Unlike MA plans, Original Medicare does not offer an out-of-pocket limit, so depending on your medical needs, your expenses could sky rocket unexpectedly.

How do you enroll in a Medicare Advantage plan?

Once you are enrolled in Part A and Part B, you can enroll in a Medicare Advantage plan during your Initial Enrollment Period, or during an enrollment period during the year. Let’s go over some Medicare enrollment periods you may be eligible for:

Initial Enrollment Period

The Initial Enrollment Period for Medicare begins three months before you turn 65, includes the month of your birthday, and ends three months after. If you are under the age of 65 and have been receiving disability benefits from the Social Security Administration or the Railroad Retirement Board for 24 months, you may also be eligible for Medicare.

Open Enrollment Period

Medicare’s Open Enrollment Period begins October 15 and ends on December 7 each year. During this period, you can make changes to your Medicare coverage, such as switching from Original Medicare to a Medicare Advantage plan, or moving from one Medicare Advantage plan (with or without prescription drug coverage) to another. You can also drop your MA plan and revert to Original Medicare during this time – and enroll in a Prescription Drug Plan.

Medicare Advantage Open Enrollment Period

From January 1 through March 31, individuals already enrolled in a Medicare Advantage plan can make one change to their coverage by switching to another Medicare Advantage plan.

Special Enrollment Period

You may qualify for a Special Enrollment Period if you experience a change in your life, like moving out of your current plan’s service area, moving back into the country after living abroad, or moving into or out of skilled nursing or long term care.