What Is Medicare Part C?

There are a few different kinds of Medicare plans that seniors have access to once they turn 65. The most powerful and comprehensive of these is Medicare Advantage, also known as Medicare Part C. This is a health insurance plan that seniors should know about and be familiar with if they are going to make an informed decision for their healthcare. What is Medicare Part C? Read on to find out!

Anyone close to 65 years of age should be considering Medicare Advantage as a health insurance plan. That’s because Advantage plans are designed specifically for seniors, covering medical expenses like hearing aids, eyeglasses, and emergency care. They are also a great replacement for Original Medicare, but they only become available to you at age 65 (or earlier if you qualify for disability). Once you are three months away from turning 65, you can start applying for Medicare Advantage. You can enroll in this plan at that time and get coverage that minimizes your out-of-pocket costs.

There is an Open Enrollment period for Medicare Advantage starting from a few months before your 65th birthday. This ends a few months after that birthday, creating a 7-month window in which you can enroll. This is the very best time to apply for Medicare Advantage, because you are guaranteed to get the plan you apply for. Insurance companies cannot say “no” to you because of any preexisting medical condition, but they could if you applied later on. They also cannot charge you more for a Medicare Advantage plan just because you have a medical condition that makes you a risk to them.

If you decide to apply later on, your next opportunity will be during annual enrollment. Starting on October 15th and ending on December 7th, this gives you a great chance to sign up for a Medicare Advantage plan before the upcoming year. Your preexisting medical conditions can affect pricing for you, and some insurance companies might not even accept your application because you are too much of a risk. If you are afraid of that happening to you, then please contact us and let us help you choose a suitable insurance provider who might be more willing to accept you.

We said Medicare Advantage is for seniors, but not all seniors will be able to get this coverage plan. Besides those who can be denied coverage due to preexisting conditions, there are also seniors who have a different kind of medical insurance plan that would conflict with Medicare Advantage. You don’t need two insurance plans providing some of the same medical benefits for you. So, if you have a Medicare Supplement (also called Medigap), or you have a healthcare plan from your employer, trust or union, there is a good chance it will overlap with the Advantage plan and be incompatible. You can simply drop that coverage plan and then apply for the Advantage plan.

If you enroll in a Medicare Advantage plan, then you can enjoy powerful coverage that keeps you from paying a lot from your own pockets. You just pay for the monthly insurance premiums and should have little else to pay for in regards to your medical care. That’s how powerful these health insurance plans are.

The basic Advantage plan will cover you for all of your emergency care, including ambulance transportation and ER care. It also covers you for any urgently needed care, which can include anything from medical tests to surgery to medications. The basic Advantage plan will include coverage for Medicare Part A (for everything except hospice benefits) and for all of Medicare Part B. This covers most of your inpatient and outpatient expenses, covering costs related to hospital stays, doctor’s office visits, medical testing, blood usage, nursing care and more.

You have some options with Medicare Part C. You don’t just have to enroll in the basic plan if you want one of these plans. There are some Advantage plans that provide even great coverage and that may help you lower your medical costs even more. The most common type of Medicare Part C plan is actually one that includes all the basic coverage that Medicare requires and then adds on coverage for a full Medicare Part C drug plan. This would take care of numerous costs associated with generic prescription drugs and help you to minimize the cost of many name brand prescription drugs. You’ll get powerful coverage that can benefit you by reducing medication costs to almost nothing, in many cases. A lot of Part D plans will only charge you $1 per prescription refill, cutting down some people’s costs by hundreds of dollars a year. That alone can pay for the cost of Medicare Part C. Check to ensure that your Part C plans includes Part D coverage, if you have multiple prescription drugs that need refilled each year.

Medicare Part C could also cover you for some routine checkup expenses. The cost of visiting your dentist, hearing specialist, general practitioner or your optometrist can all be covered by a Medicare Part C plan. Some of these plans will cover you for multiple visits, and they can cover hearing aids and prescription eyeglasses as well. It’s not just the visit that is covered, though. In many cases, your dental cleanings, x-rays, medical tests and more will be covered along with the basic checkup costs.

Which one of these should you sign up for? If you have questions, you can always direct them to us and get some help over the phone. Feel free to contact us. Just bear in mind as you search for the right Advantage plan, you will need one that is relevant to you. Make certain that the plan you pick covers those expenses you are paying for out of pocket and that it is an affordable plan for you. It might be a good idea to spring for some extra coverage just to provide you with some added protection and peace of mind.

Enrolling in a Part C plan comes with some limitations. You won’t be able to take your Medicare Part C health insurance plan and expect to be covered at every hospital, clinic and doctor’s office. There will be some that are not a part of your insurance company’s network. These off-network facilities have never agreed to honor your insurance provider’s Advantage plans.

What does that mean for you? It means that you could be expected to cover some or all of the medical care costs at those facilities. Your Medicare Advantage plan might not be any good outside of your insurance company’s network of healthcare providers.

This is especially true if you go with the standard Medicare Advantage plan. This is known as an HMO plan, and it covers you only within your insurance company’s network. Outside the network, you are expected to pay for all medical care, even if that care would normally be covered by your Advantage plan. The only time there is an exception made for this is when you have a medical emergency and have to go to an off-network care facility. In those cases, your Advantage plan should provide some coverage for you.

For those seniors who want Medicare Advantage from a specific insurer who doesn’t have any network facilities in their area, there are PPO plans. These give you coverage on the network, and then if you go off the network, you get partial coverage. A PPO Advantage plan is going to cost more than an HMO plan, though so keep that in mind.

You may also be able to find POS plans, which are Advantage plans that cover you fully on the network and then give you a predetermined price for any healthcare services outside the network. You could qualify for a Special Needs plans as well, and you can talk to us if you would like to find out about your eligibility. Most insurance companies only offer a couple different network options for their Advantage plans, though, so the HMO and PPO may be your only choices in some areas and from some providers.

Looking to keep medical care costs as low as possible? Medicare Part C can help you do that, but these plans can also be kind of expensive. There isn’t any standard pricing for Advantage plans, so you can end up paying way more than you have to for the exact same coverage that could get somewhere else.

The best way to ensure you ae not overpaying for your Advantage plan insurance is to source multiple quotes and then compare them to find the best deal. You can source quotes here on our site. Just search using your zip code and find out how much it costs to get a Medicare Part C plan where you live. You always want to factor in the local area, as prices on Medicare Part C change based on location.

It’s really simple to find great deals on Medicare Advantage plans through our site and the free tools we have here. You can search as much as you like and give us a call for free, expert advice. Get the answers you are looking for and find out what is Medicare Part C by using the resources we have available for you. This is a type of health insurance plan that could save you hundreds of dollars a year, and many seniors are already enrolled in Part C plans and saving money this year.