Medicare Part C Coverage in 2019 | Medigap Life

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Individuals who are interested in a more robust set of benefits might find that they are looking for more than what Medicare Part A and Part B can provide. Thankfully, there is another alternative called Medicare Part C. You may have also heard this plan referred to as Medicare Advantage, and essentially it combines the benefits of Parts A and B while adding extra features.

Medicare Advantage enrollees must currently receive benefits through Parts A and B in order to be eligible for Part C. Rather than having your expenses covered through Medicare’s federally funded system, a private health insurance company will administer your Advantage benefits. The only exception to this is when hospice care is requested, which will continue to fall under the purview of Part A.

How Part C Works

Both the hospital and medical benefits offered through Original Medicare are included under the Advantage plan, allowing you to receive help with covering the costs of a hospital stay, skilled nursing needs, routine visits to your primary care physician, and more. One of the more attractive portions about Medicare Part C has to do with the additional benefits that are often included in many of these plans.

Part C enrollees usually have coverage toward prescription drugs, dental care, vision services including eyeglasses, hearing care, wellness benefits, and more. Keep in mind that each Advantage plan will have its own set of stipulations, so selecting the combination of benefits that will best meet your medical needs is important.

Costs And Considerations

For most individuals, Medicare Part A is free of charge while Part B does include a monthly premium. Medicare Advantage, or Part C, is much the same, where you are still responsible for your Part B premium plus any costs associated with Part A. However, various deductibles, copayments, and coinsurance will also apply to this coverage.

Each Medicare plan sets its own pricing and is subject to change each year. You’ll be able to review a range of cost options before you select your plan, as some are geared more toward individuals who need frequent care while others might include higher deductibles but smaller premiums if you intend on using your coverage irregularly.

Thankfully, Medicare Advantage plans are legally required to place a limit on out of pocket expenses, so even if unforeseen medical events occur, you will only be responsible for so much of the cost before your coverage would handle the rest.

Working With Your Provider

Medicare Advantage plans are unique in that they do allow for various cost structuring depending on the providers you visit for your care. It’s important to always verify the Medicare Advantage company you enroll with accepts your physician as they each have certain in-network doctors that accept these plans.

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