Medicare Advantage plans, or Medicare Part C plans, are comprehensive plans that include the same benefits of Medicare Parts A and B plus additional coverage. This is important if you require services beyond what Original Medicare covers.

What Does Medicare Part C Cover?

These health plans cover all the benefits of Medicare Part A, including hospital stays, skilled nursing care and home health care, but not hospice care (which is still covered by your Part A benefit). These plans also cover all the benefits of Medicare Part B, including doctor visits, outpatient care, screenings, shots and lab tests.

Many Medicare Advantage Plans also include Medicare Part D prescription drug coverage. Medicare Advantage plans work similarly to employer-sponsored health insurance plans that you may have had or currently have, which may help you continue a similar level of coverage to what you have now.


What Does Medicare Part C Cover Compared To Original Medicare?

In addition to covering Parts A and B of Medicare, many Part C plans also offer additional benefits not included in Original Medicare, such as Part D coverage for prescription drugs. Because of this, nearly 22 million of the 64 million people who applied for Medicare chose Medicare Advantage plans.

Part A of Original Medicare covers hospitalization, home care, and other inpatient medical requirements, and Part B. Outpatient treatment, including doctor visits, diagnostic procedures, screenings, and preventive care, are covered in Part B.

Many people may need more coverage for their health needs. For example, Original Medicare doesn’t have prescription drug coverage. Private insurers offer Medicare Part D coverage, but even then, there still may be areas of your healthcare where you need protection. That’s where Medicare Part C plans come in.

What Are Medicare Part C (Medicare Advantage) Costs?

Where you live affects how much Medicare Part C plans (commonly known as Medicare Advantage plans) cost. There are plans with $0 premiums.  Although some Medicare Advantage plans will assist with the cost of your Part B premium, you still have to pay it even though your monthly premiums are often lower than what you pay for Medicare Part B. You get coverage for Parts A and B as well as other additional benefits with a Medicare Part C plan that you don’t get with Original Medicare.

  • The cost of Medicare Part C varies from state to state and from plan to plan. However, there are a few fundamental elements that affect your Medicare Part C costs:
    The regular monthly plan premium, which normally varies from $0 to $200
  • How much of your Medicare Part B expenses are covered by your Part C plan
  • Your copayment amounts for various medical services

Medicare Advantage Plan Types:

HMO Plans-Health Maintenance Organization

  • Typically requires you to receive services from a network of local providers; except for emergency room, urgent care visits and renal dialysis services.
  • Often require referrals to specialists, depending on the plan.
  • Out-of-pocket costs are typically lower than PPO and POS plans.

POS Plans-Point-of-Service

  • Similar to an HMO plan, but you can also see providers for certain services outside the provider network; generally, at a higher cost.
  • Referrals to specialists may be required, depending on the plan.
  • Out-of-pocket costs are typically higher than HMO plans, but lower than PPO plans.

PPO Plans-Preferred Provider Organization

  • You can see providers for all covered services outside the provider network, generally at a higher cost.
  • Don’t require referrals to specialists.
  • Out-of-pocket costs are typically higher than HMO and POS plans

Who Is Eligible For Medicare Part C?

In order to be qualified for a Medicare Part C plan:

  • You must have Original Medicare coverage (Medicare Parts A and B).
  • During your enrollment time, you must choose a Medicare Part C insurance company that is providing the coverage you desire. 
  • You can compare Medicare Part Part C plans and evaluate prices from Part C insurers during the enrollment period. 
  • Consider your prices and the coverage that is most important to you.

How Do I Sign Up For Medicare Part C?

You can select a Medicare Advantage plan during the Initial Enrollment Period if you are applying for Medicare for the first time (IEP). This seven-month span contains the following:

  • three months prior to turning 65
  • Month of your 65th birthday
  •  three months following your 65th birthday

If you already have Original Medicare, you can switch to a Medicare Advantage (Part C) plan between October 15 and December 7 during the Medicare Annual Enrollment Period (AEP). During this time, if you’re currently enrolled in a Medicare Advantage plan, you can change to a different one.

Help With Your Medicare Part C Plan Costs

 A Medicare Savings Program may be able to assist you with Medicare Part C expenses. These programs assist with paying for Medicare Part C premiums and other expenditures from your plan if you are currently enrolled in Medicare Part A and Part B and fulfill the criteria for low income, disability, or other chronic health conditions.

Review Medicare Part C plan costs and coverage. Find a plan that fits you.

*By completing this form, you agree that an authorized representative or licensed insurance agent may contact you by phone,email,text, mail or face to face to answer your questions or provide additional information about your Medicare plan options. Not affiliated or endorsed by Medicare or any state or federal governmental agency.