Medicare Part C

What is Part C?

Medicare Part C is also referred to as "Medicare Advantage." Medicare Part C is offered only by private companies with a Medicare contract. If you join a Medicare Advantage Plan, the plan will provide Part A (Hospital Insurance) and Part B (Medical Insurance).

What Does Part C Cost?

Today, many Medicare Advantage Plans are eliminating their monthly premiums. Complementary to the removal of premiums, the out-of-pocket costs for these plans are typically lower than the out-of-pocket costs in Original Medicare (4). There are different out-of-pocket costs associated with different Medicare Advantage Plans, so it's important to do your research. Your out-of-pocket costs for Medicare Part C are dependent on (1):

If the plan charges a monthly premium. If the plan pays any of your monthly Part B premium. If the plan has a yearly deductible or any additional deductibles. The fees for each visit or service (copayments or coinsurance). The type of health care services you need and how frequently you receive them. If you follow the rules of the plan, like using network providers. If you need extra benefits and if any costs are associated to these benefits. The plan's yearly limit on out-of-pocket costs for all your medical services.

If the Plan pays any of your Part B premium, also known as Part B Premium Reduction:

The Medicare Part B premium is covered for full Dual Eligible members Premiums, co-pays, co-insurance, and deductibles may vary based on the level of help received for Dual Eligible SNP members

What Does Part C Cover?

Remember, everything that is covered by Part A and Part B is covered with a Medicare Advantage Plan. If you are covered by a Medicare Advantage Plan, you receive coverage for all medically necessary services, including emergency and urgent care. Private companies that offer Medicare Part C usually have networks of doctors, and this may mean that you will have to see your plan's doctors in order to receive care. When making your decision on Medicare Part C, it's a good idea to ask if the doctors near your home are included in their network.

With the exception of hospice care, Medicare Advantage plans are required to cover all of the services that Original Medicare covers. Original Medicare covers hospice care even if you're are enrolled in Medicare Part C. Medicare Advantage Plans are not supplemental coverage.

When Can You Enroll in a Medicare Advantage Plan?

Each year, there is a specific time when you can enroll in a Medicare Advantage Plan called the Annual Election Period. Get your daily planner and Google Calendar ready; the 2012 Annual Election Period is scheduled for October 15-December 7, 2011. With the exception of those beneficiaries that become eligible for an Initial Enrollment Period or Special Enrollment Period, this is the time period that applies to you. The time frame for the Annual Election Period is subject to change from year to year, so make sure to check for updates!

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