Medicare Part C, also known as a Medicare Advantage Plan, are insurance plans by third parties that Medicare has approved. These plans will incorporate your Part A (Hospital Insurance), Part B (Medical Insurance), and some include Part D (Prescription Drug Coverage). In addition to these Parts, you may be able to also get dental, vision, and hearing coverage you may not have otherwise received. You can join a Medicare Advantage plan with any pre-existing condition except end-stage renal disease.
Because Medicare is strict about these plans, the companies who participate in Medicare Advantage Plans follow strict rules. These companies get a fixed rate each month for your care, however, they can set their own rules for out of pocket expenses and whether or not you will need to get a referral before seeing a specialist or if it is necessary for you to only see your preferred provider. Some plans will also give you the option to enroll in a Medical Savings Account, or MSA, that allows you to have a higher deductible and a bank corresponding back account. Medicare will deposit money into the account and you will be able to use that money for services rendered during the year.
A Medicare Advantage Plan makes sure you are always covered for any emergency services you need and will cover any services your Original Medicare covered except hospice care but if you require hospice care, your Original Medicare will cover that.
If you are an existing Medicare Advantage Plan member you may make changes to your plan the first 6 weeks of the year. You may also leave your plan at this time and return to Original Medicare coverage. You may not however do any of the following:
- Make changes to your Medicare MSA (Medical Savings Account)
- Change from one Advantage Plan to another
- Switch your drug plan to another
- Start up Medicare Advantage from Original Medicare
As with any insurance plan, make sure to check all aspects of the plan before committing to it. All rules must be followed so knowing ahead of time if you need a referral or prior authorization for procedures is key. Knowing your out of pocket costs ahead of time can save a lot of turmoil for the future.
