Medicare Part C:
Medicare Advantage
Medicare Part C, sometimes called “Medicare Advantage” or “MA,” is offered by private insurance companies approved by Medicare. Medicare pays these companies to cover your Medicare Part A and B benefits.
Medicare Part C must cover all of the services that Original Medicare covers except hospice care. Original Medicare covers hospice care even if you’re in a Medicare Part C plan. In all types of Part C plans, you’re always covered for emergency and urgent care. Depending on your area, Part C plans may also offer extra benefits, such as:
- Vision
- Dental
- Hearing
- Fitness & Wellness
- Telehealth
- Over-the-Counter Allowance
- Transportation
- And maybe more!
Medicare Made Easy Part Three: Medicare Advantage Plans
What are the Perks of Medicare Part C? (Medicare Advantage)
Bundled Coverage
Medicare Part C can help you bundle your coverage so that instead of having Original Medicare and multiple stand-alone plans for prescriptions, vision, or dental care, all that coverage flows through one plan instead.Cost Savings
Many Medicare Part C plans offer premiums, deductibles, and copays as low as $0. Depending on your current coverage and the Medicare Advantage Plans available in your area, an MA plan may be able to save you money on healthcare costs.Maximum Annual Out of Pocket Limit
With Medicare Part C, you will have a maximum out-of-pocket limit on health costs for yearly spending. Once you have reached that limit, covered services will cost you $0. All plans are different and change on a yearly basis, so make sure you do your research before choosing a plan.
Types of Medicare Part C (Medicare Advantage)
Here are the different types of Medicare Advantage Plans:
- Health Maintenance Organizations (HMOs)
- Preferred Provider Organizations (PPOs)
- Private Fee-For-Service (PFFS)
- Special Needs Plans (SNPs)
Other options include HMO Point-of-Service (HMO POS) and Medical Savings Account (MSA) plans.
Not all Medicare Advantage plans are the same. It is important to always research the costs and benefits of each plan. Make sure to consider the medications that you are taking. Some Medicare Part C plans cover prescription drugs, while others do not.
A licensed health insurance agent can help you find and compare Medicare Advantage plans in your area so you find the benefits that are important to you, understand your likely costs or savings under the plan, and know whether your providers are in-network. They can also help you enroll in the plan of your choice.
Medicare Advantage (Part C) Eligibility
When it comes to Medicare Part C eligibility, you must have Medicare Parts A and B and live in the plan’s service area. You will have options for Medicare Advantage Plans and you may be able to join certain Special Needs Plans, like a Chronic Condition Special Needs Plan (C-SNP).
Enrollment for Medicare Part C is not open at all times, but you may be eligible to enroll if you have recently obtained Medicare Parts A and B, if you have recently lost health coverage, or if it is the Medicare Annual Enrollment Period (Oct. 15 – Dec. 7).
Enrollment Eligibility
Annual Enrollment Period (AEP)
Medicare Annual Enrollment Period runs each year from October 15 to December 7. What is the Annual Enrollment Period vs. Open Enrollment Period?
Initial Enrollment Period (IEP)
Your Initial Enrollment Period generally surrounds your 65th birthday but may occur if you otherwise become eligible for Medicare for the first time.
Special Enrollment Period (SEP)
You may be eligible if you experience a qualifying life event such as moving to a new zip code, losing employer coverage, or change in Medicaid status.
Further Reading:
e-TeleQuote Insurance Inc. (“e-TeleQuote”) does business as easyMed Insurance Services in all states other than New Mexico. e-TeleQuote is a duly licensed insurance agency appointed by Medicare Advantage HMO, PPO and PFFS plans and stand-alone prescription drug plans and insurance companies holding Medicare contracts approved by The Centers for Medicare & Medicaid Services (CMS). e-TeleQuote is not connected with or endorsed by the U.S. Government or the Federal Medicare Program. Enrollment in any plan for coverage is subject to insurance company approval. Enrollment in the plan depends on the plan’s contract renewal with Medicare. By using e-TeleQuote’s easyMedicare website, you understand and agree that in New Mexico, we operate as e-TeleQuote Insurance, Inc. (Your IP address and/or location coordinates may be gathered to verify your location.) Sales agents may be compensated based on your enrollment in a health plan. Medicare Supplement plans are not connected with or endorsed by the U.S. Government or the Federal Medicare program. e-TeleQuote complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity, or religion. easyMedicare.com is a non-government site, powered by e-TeleQuote Insurance, Inc. e-TeleQuote provides a secure way to purchase Medicare insurance from the comfort of your home or workplace. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-Medicare (TTY users should call 1-877-486-2048) 24 hours day/7 days a week, or your local State Health Insurance Program (SHIP), to get information on all of your options. Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply. To send a complaint to Medicare, call 1-800-MEDICARE (TTY users should call 1- 877-486-2048), 24 hours a day/7 days a week). If your complaint involves a broker or agent, be sure to include the name of the person when filing your grievance.
Last Updated: September 30, 2024
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