Medicare: What is a Part C or Advantage Plan?

June 12, 2020 // By Kim Kozak

You keep hearing these terms “Medicare Advantage” or “Part C” plans, but what does that mean? Let’s explore!

Let’s start by clarifying, Medicare Advantage Plans and Medicare Part C Plans are two names for the same products. These two terms are used interchangeably by insurance companies and insurance agents, which can be a bit confusing. 

What exactly are these plans? Medicare Advantage Plans are Medicare plans administered by insurance companies that offer coverage beyond what is provided with your original Medicare red and blue card. These plans include all benefits and services covered under Part A and Part B (original Medicare), and in many cases include prescription drug coverage and extra benefits. These Part C plans may have premiums, deductibles, co-pays, co-insurance, and provider network limitations. The plan options include PPOs, HMO’s, and more. 

So, what about these “extra benefits”? Most of the insurance carriers run commercials and send out mailings advertising their Medicare Advantage plans during the Annual Enrollment Period from October 15th-Dec 7th every year. They often promote the “extra benefits” available on the plans. These benefits can include dental, health and wellness programs, fitness classes or gym memberships, vision, hearing aids, transportation to healthcare appointments, etc. 

Who qualifies for these plans? Medicare Advantage Plans are very likely an option for individuals who are new to Medicare and those who are already on Medicare. If you are already on Medicare and want to switch to a Part C plan, you’ll need to check with your agent about your particular situation. 

As always with Medicare, whether an advantage plan is the right choice for you is a very individual decision based on many factors. If you think you might be interested in exploring Medicare Part C plans, call us today to make an educational appointment. Medicare requires that you wait until the Annual Enrollment Period to switch your coverage, which would begin January 1st of the following year. However, it’s a good idea to make an appointment, learn about the Medicare Advantage process and the plans now, and be ready to confidently make your enrollment decision in the fall.

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Medicare Part D Explained

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Medicare Part B: What Does It Cover?