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Medicare Part C: What You Need to Know
What is Medicare Part C?
Medicare Part C provides an alternative to Original Medicare (Medicare Part A and Medicare Part B). Offered by private health insurance companies that are approved by Medicare, Medicare Part C plans—also known as Medicare Advantage plans—are legally required to offer at least the same benefits that are provided by Original Medicare, but may include additional routine coverage.
With a Medicare Part C Plan:
- You receive the same coverage offered by Original Medicare
- Additional routine benefits not included in Original Medicare may be available
Who is eligible to receive Medicare Part C coverage?
Any Medicare beneficiary, regardless of age, can purchase a Medicare Part C plan if they meet the following criteria:
- Enrolled in both Medicare Part A and B: Some people mistakenly think they can drop Part B if they enroll in a Medicare Part C plan. However, if Part B is dropped, you will immediately lose your Part C plan, so it is important to keep both Parts A and B when enrolling in Medicare Part C.
- Choose a Plan in the County You Reside: Eligibility for Medicare Part C plans is based on the address you have on file with Social Security. You must choose a plan that operates in the county in which you live. Some plans will be specific to only one or two counties, while others might span the whole state.
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The Cost of Medicare Part C
As mentioned above, Medicare Part C is an alternative to Original Medicare. Therefore, the same hospital and doctor benefits provided by Original Medicare are also provided by a Medicare Part C plan. However, instead of paying deductibles and 20% of your medical services, you will pay the Medicare Part C plan copays.Each Medicare Part C plan has a summary of benefits, which will list out various medical services and provide a summary that shows you what your copay or coinsurance will be for each service. Everything you spend on Part A and B services counts toward your out-of-pocket maximum. If you hit that maximum, your Part C plan will pay 100% after that for the rest of the year.
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Enrolling in Medicare Part C
You can enroll in a Medicare Part C plan during your Initial Enrollment Period, if you qualify for a Special Enrollment Period or during the Medicare Annual Enrollment Period, held each year October 15 to December 7.The Medicare Advantage Open Enrollment Period (OEP) runs January 1 to March 31. If you are enrolled in a Medicare Part C plan, you have a one-time opportunity to:
- Switch to a different Medicare Part C plan
- Drop Medicare Part C and return to Original Medicare (Parts A and B)
- Sign up for a stand-alone Medicare Part D Prescription Drug plan if you elected to return to an Original Medicare plan
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We’re here to help you find the right Medicare Part C coverage for your needs. In just minutes, we can compare Medicare Advantage options that may be available in your area. It’s free and there’s no obligation to enroll.
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