Part C of Medicare is a supplement to Original Medicare that is accessible through Medicare Advantage plans (Part A and Part B). Medicare Advantage plans are private health insurance plans approved by Medicare that are sold by private health insurance firms. Medicare Advantage health plans (such as HMOs and PPOs) must provide at least the same benefits as Original Medicare, but they can also include extra benefits such as routine vision or dental coverage, health wellness programs, or prescription medicines.
One of the advantages of Medicare Advantage plans is that your prescription drug benefits (Medicare Part D) are included in the same plan, rather than having to enroll in a separate Medicare Prescription Drug Plan. These plans, also known as Medicare Advantage Prescription Drug Plans, allow you to combine your Medicare Part A, Part B, and Part D coverage into a single plan. You should enroll in a Medicare Advantage plan that includes prescription drug coverage if you desire this coverage; you should not enroll in a Medicare Prescription Drug Plan, which normally works with Original Medicare. Medicare Advantage plan costs and coverage details can vary depending on the insurance company and county that you live in.
The different types of Medicare Advantage plans are: Health Maintenance (HMO) plans, Provider Organization (PPO) plans, Private Fee-for Service(PFFS) plans, Special Needs Plans (SNPs), and Medicare Medical Savings Account (MSA) plans.
In order to be eligible for Medicare Part C, you must be enrolled in both parts of Original Medicare (Part A and Part B). Once you have Medicare Part A and Part B, you are generally able to enroll in a Medicare Advantage plan, provided you live in the plan’s service area and do not have end-stage renal disease (ESRD).
Even if you have end-stage renal disease, you may be allowed to enroll in a Medicare Advantage plan under certain circumstances. If you’re enrolling in a Special Needs Plan for people with end-stage renal disease, for example, you might be qualified for this form of Medicare Advantage plan. You can call 1-800-MEDICARE (1-800-633-4227), which is available 24 hours a day, seven days a week. For TTY users, dial 1-877-486-2048.
Before enrolling in a Medicare Advantage plan, those with other health insurance coverage (such as a union or employer-sponsored health plan) should learn more about their current coverage. It’s probable that after you join in a Medicare Advantage plan, you’ll lose your current coverage. Furthermore, you may not be able to reinstate your original Medicare Part C coverage if you change your mind after discontinuing the other plan. Before enrolling in another health-care plan, it’s a good idea to verify with your existing benefits administrator.
