Medicare Part C

• Admin
• 25 Jan 2025

Medicare Part C (Medicare Advantage)

Medicare Part C, also known as Medicare Advantage (MA), is one of your options as you consider how to get your Medicare benefits. When you qualify for Medicare, you can get your Part A and Part B coverage through Original Medicare or through a Medicare Advantage plan. Original Medicare is administered by the federal government, but Medicare Advantage plans are offered by private insurance companies who contract with Medicare to provide your benefits.

MA plans are required to include at least the same coverage as Original Medicare Part A and Part B, but most plans will include additional insurance coverage. Because they are offered by private companies, costs and coverage can vary between Medicare Advantage plans.

What benefits could be included in a Medicare Advantage (MA) plan?

As mentioned, MA plans will include Part A (hospital insurance) and Part B (medical insurance) benefits, but many plans include a wide range of extra benefits that may include:

• Prescription drug coverage
• Vision care, including glasses and contacts
• Routine dental care
• Hearing exams and coverage for hearing aids
• Fitness programs and gym memberships
• Over-the-counter allowances
• And more

Plans vary, so it’s important to compare plans available in your area before enrolling. The idea of having a single plan that meets your comprehensive insurance needs appeals to many Medicare recipients.

Will a Medicare Advantage plan help lower my healthcare costs?

Medicare Advantage plans may help lower your overall medical costs. Many plans offer additional benefits above and beyond Part A and Part B with little to no additional cost to you. MA plans also have an annual out-of-pocket maximum limit. This means that once you’ve reached that limit, you will pay nothing for the remainder of the year for any covered medical expenses you may incur. Unlike MA plans, Original Medicare does not offer an out-of-pocket limit, so depending on your medical needs, your expenses could skyrocket unexpectedly.

How do you enroll in a Medicare Advantage plan?

Once you are enrolled in Part A and Part B, you can enroll in a Medicare Advantage plan during your Initial Enrollment Period, or during an enrollment period during the year. Let’s go over some Medicare enrollment periods you may be eligible for:

• Initial Enrollment Period: This begins three months before you turn 65, includes your birthday month, and ends three months after. If you are under 65 and have been receiving disability benefits from the Social Security Administration or the Railroad Retirement Board for 24 months, you may also be eligible.
• Open Enrollment Period: Occurs annually from October 15 to December 7. During this time, you can switch from Original Medicare to a Medicare Advantage plan, switch between MA plans, or return to Original Medicare and enroll in a Prescription Drug Plan.
• Medicare Advantage Open Enrollment Period: From January 1 to March 31, individuals already enrolled in a Medicare Advantage plan can switch to another MA plan or return to Original Medicare.
• Special Enrollment Period: You may qualify if you experience specific life changes such as moving out of your plan’s service area, returning to the U.S. after living abroad, or entering or leaving a care facility.