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MEDICARE PART C

What is Medicare Part C (Medicare Advantage)?

Medicare Part C, are privately managed senior health insurance plans. Carriers that participate in the Medicare Advantage program must submit their plan designs to CMS for approval.

As with any health insurance plans, Advantage plans change almost every year. Some plans are discontinued while other new plans appear as replacements.

Is Medicare Advantage Right For You?

Medicare Advantage plans are private health plans that generally provide all the coverage of original Medicare. Almost all Medicare Advantage plans have strict doctor and hospital networks. If you fail to utilize participating providers your out of pocket expenses will be considerably greater than using par providers.

Unfortunately, many doctors do not participate in ANY Medicare Advantage plans. If you enroll in an Advantage plan you must check your current doctors and prescription medications every year during open enrollment against next year’s list of participating providers and drug formulary.

Most (but not all) plans also include Medicare Part D prescription drug coverage. These plans are referred to as Medicare Advantage with Prescription Drug (MAPD) coverage.

Below are types of Medicare Advantage plans:

  • Medicare Health Maintenance Organization (HMOs)
  • Preferred Provider Organizations (PPO)
  • Private Fee-for-Service Plans
  • Medicare Special Needs Plans
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