Original Medicare is the federal Medicare program that is available to eligible Americans 65 or older, or individuals who qualify under 65 due to certain disabilities. For many seniors, Medicare plays a vital role in providing access to affordable healthcare services, including inpatient care, outpatient treatment and prescription drug therapy.
Benefits through Medicare are offered through the program’s various parts. These include:
- Medicare Part A – Inpatient care coverage
- Medicare Part B – Outpatient care coverage
- Medicare Part C – Medicare Advantage
- Medicare Part D – Prescription drug coverage
Medicare Part C may be an option worth considering if you’re looking for Parts A, B, and D all under one umbrella – along with additional benefits and coverage of healthcare services.
What is Medicare Part C?
Medicare Part C, also known as Medicare Advantage, is a type of plan that is offered by private health insurance companies. It includes all of the same benefits as Original Medicare, but Part C plans can also include additional benefits not found in Original Medicare. These additional benefits are created by the plan provider and may include dental benefits, vision benefits, gym memberships and more.
Are There Different Types of Part C Plans?
Because Medicare Part C coverage is supplied by private insurance companies, plans can differ greatly in what they have to offer. The core of each Medicare Advantage plan must include the basic coverage of Original Medicare benefits per regulations supported by the Centers for Medicare & Medicaid Services (CMS), so all Medicare Advantage plans have this in common; however, this is where the similarities end.
There are different types of Part C plans based on how the provider has benefits structured. Below is a list of common variations of Type C plans:
- Health Maintenance Organization (HMO)
- Preferred Provider Organization (PPO)
- Private Fee-For Service (PFFS)
- Special Needs Plan (SNP)
Each of these different types of Medicare Advantage plans includes varying benefits and restrictions. For instance, an HMO usually requires that you utilize medical service providers within the plan’s network. A PPO, on the other hand, allows you to seek treatment from any medical service provider, but you will receive a discounted rate for utilizing in-network providers in most cases.
Deciding which type of Medicare Part C plan to go with may come down to what is available in your area. Not all Medicare Advantage providers offer the same types of plans, and different states have different regulations regarding what can be offered. As such, you may find that you are limited to certain coverage options based on location.
Work With an Independent Insurance Advisor
If you’re having a hard time finding the right Medicare Part C plan, you’re encouraged to work with an independent Medicare benefits advisor. Sometimes referred to as a licensed agent or broker, an independent Medicare benefits advisor can impartially shop Part C plans from a number of providers in your area to help you analyze your options and find the plan that works for your specific healthcare needs.