Medicare Advantage plans (Part C) provide Medicare coverage through government-approved private health insurance companies. Part C plans often have lower cost sharing and a maximum annual out-of-pocket cost.
These plans can be HMO, PPO, Regional PPO, or Private Fee-for-Service plans and may vary depending on where you live. Plans may have a defined geographic service area or network of doctors and hospitals where you can receive care.
Medicare Part C
Medicare Advantage plans provide all Part A and Part B services, and most plans cover prescription drugs. Some plans offer additional services like dental, vision and hearing benefits, and wellness programs.
Premiums are paid to the private insurer and vary by plan and can change each year. You must continue to pay your Part B premium.
Plans may have a deductible and amounts vary from plan to plan.
Plans may charge a copay for specific services, like doctor office visits. Copays may also apply to prescription drugs.
A cost share may apply for some services.
All Medicare Advantage plans have an annual limit on your out-of-pocket expenses. Original Medicare does not have an out-of-pocket limit.
Once enrolled in Parts A and B, you can enroll in a Medicare Advantage plan offered by Medicare-approved private insurers where you live.
You can join a Medicare Advantage plan during your Initial Enrollment Period when you first become eligible for Medicare. You can also enroll during the Annual Enrollment Period from October 15 to December 7 each year. During this time, any qualified Medicare member can join a Medicare Advantage plan or switch Medicare Ad vantage plans for coverage starting January 1.
Contact a Medicare-approved private insurer for help choosing a plan and getting enrolled.
Now that you’ve learned about Medicare Advantage Plans and how they work, we can help you compare options to find what’s right for you.