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Medicare Basics

Medicare Part C

Medicare Part C, also known as Medicare Advantage plans, allows you to receive your benefits from a private insurance company approved by Medicare.

If you have Medicare Part A and Medicare Part B, you can receive your benefits from a Medicare Advantage plan. Medicare Advantage plans are not supplemental insurance, but rather health insurance plans of their own.

Medicare Advantage plan features include:

  • May require you to pay additional premiums, co-payments, co-insurance, deductibles, or other out-of-pocket expenses, but offer a yearly limit on out-of-pocket costs
  • Must be approved by the Centers for Medicare and Medicaid Services (CMS), the federal agency that oversees the Medicare program
  • Must maintain a contract with CMS to provide Medicare coverage
  • May offer prescription drug coverage (see Medicare Part D) as part of their plan offering
  • May require you to use a specific network of doctors and hospitals

Medicare Part C Payments and Enrollment

With a Part C plan, you may be able to lower your out-of-pocket costs. Some Medicare Advantage plans have lower co-payments than Medicare Parts A and B, but are also limited to certain service areas and often involve networks. You may have to pay a premium each month due to the extra benefits the plan may provide. The amount you pay out-of-pocket varies from plan to plan. Compare plans carefully to determine which plan best suits your needs and your budget.

You can enroll in a Medicare Advantage Plan during your Initial Enrollment Period and the Medicare Advantage and Prescription Drug Plan Annual Enrollment Period. There are also Special Enrollment Periods for certain situations.