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Part C Coverage – Alternative to Original Medicare

Medicare Advantage plans, “MA Plans” or simply “Part C”, are offered as an alternative to Original Medicare. It has Part A and B’s coverages plus prescription drug (Part D) and other programs and services. Only private Medicare-approved companies offer these Medicare Advantage health insurance plans so make sure you do your assignment and only avail from a trusted provider.

Coverage of Part C

So, what does it cover? While Part A covers inpatient hospitalization and Part B covers for outpatient, medical care, Part C covers both plus prescription drug coverage (Part D) and other medical benefits and services not covered under the Original Medicare.

Part C may offer many of same preventive benefits found in HMOs (Health Management Organization) and PPOs (Preferred Provider Organizations) which may include:

  • Prescription drug coverage
  • Dental (routine dental care including X-rays, exams, and dentures)
  • Vision (including glasses and contacts)
  • Hearing (including testing and hearing aids)
  • Wellness programs and fitness center memberships
  • Worldwide Emergency and Urgent care coverage.

Pros and Cons of Medicare Advantage Plans

– Your coverage is combined into one simple plan.
– Costs that may be less than those of Original Medicare.
– Extra benefits include vision, hearing, and dental care, as well as wellness programs and discounts on health-related merchandise.
– Prescription medicine coverage (if included in the plan).  
– All of the rights and protections provided under the Medicare program.   – If you qualify, you may receive assistance in paying your premiums (subsidies).
– All the advantages of Medicare Part A and Part B plan, without obtaining supplemental insurance.
– If you choose an HMO Medicare Advantage plan, you may only have a limited number of providers to choose from.
– Out-of-network providers may cost more.
– Other plan alternatives, on the other hand, will give a broader provider network.
– Certain plans may charge you more for items like prescription deductibles and specialist visits.
– If you travel frequently, your plan may not cover treatments provided outside of your coverage region.

Part C Eligibility

To apply for Part C, you must be enrolled in Medicare Parts A and B. You can only enroll during the Medicare Annual Enrollment Period (AEP), which is from October 15 to December 7. You can switch to a different MA plan during the same period if you’re already enrolled in one.

Should You Enroll in A Medicare Advantage Plan?

There is no one answer for all. As general advice, you’ll have to examine your needs and check if your Original Medicare covers all that you need. If not, then perhaps consider enrolling in MA Plans.

To see if you can avail of Part C, contact us and we gladly assist you to avail on the soonest enrollment period.

Similarities and Differences between Part C and Part D

Part D covers only prescription medications. So if you just want to add prescription drugs to your Original Medicare plan, then enrolling in Part D is advised.

Part C also covers prescription medications but has more auxiliary benefits such as dental, vision, and wellness provisions. Those who are looking for a total healthcare plan might be better suited for Plan C.