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Understanding Medicare- Part C


Part C- Medicare Part C, otherwise known as Medicare Advantage is a program that allows you to enroll in private health insurance that offers both Medicare Part A and B benefits. These are separate health insurance plans rather than supplemental insurance. Medicare Advantage can also include prescription drug coverage in addition to vision, hearing, and dental.

There are many different options for Advantage plans including:

1. Health Maintenance Organizations (HMO) – These plans are required to cover both Part A and Part B healthcare, but can also offer additional benefits. You are limited to physicians and hospitals that are within the network except for emergency care. These plans can lower costs making them less expensive than traditional Medicare plans

2. Preferred Provider Organizations (PPO)– These plans allow you to use doctors, hospitals, and specialists within the network but unlike HMOs you are allowed to use health providers outside the network at an additional cost to you without a referral.

3. Private Fee for Service (PFFS)- With this plan you can use any physician as long as they abide by the terms of the PFFS. This plan chooses how much it will pay for the services and you can spend more or less on PFFS plans than on the traditional Medicare Plans.

4. Medicare Special Needs- These plans are limited to people with certain diseases, disabilities, or other health needs and are customized to the needs of that specific group, for example those who have diabetes. These plans also include the Medicare Part D prescription medication coverage.

In addition to these plans, if you enroll in a Medical Savings Account you do not have to pay a monthly premium because you pay a high deductible. Once you pay for the Medicare Part B premium, pay for Medicare covered services, and reach the deductible, the plan will pay for Medicare services. These accounts do not include prescription drugs.

If you have questions choosing a Medicare plan that offers the coverage you need, contact us at MedicareSolutions at 1-800-328-7305 where a licensed sales agent will immediately assist you.


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