Medicare Part C is an alternative to Original Medicare, which is the healthcare program administered by the federal government. Part C plans, also known as Medicare Advantage plans, will give you the same Part A and Part B coverage you’d get under Original Medicare with additional benefits.
Some of these plans offer health coverage benefits like transportation to and from appointments or gym memberships. If you’re wondering “What is Part C?” and if it’s right for you, we’ll go over some of the basics.
What is Medicare Part C?
Medicare Part C plans are offered by private insurance companies. They give you the same benefits that Original Medicare offers along with additional coverage. Benefits can vary. If you already have Medicare Part A and Part B, you’re eligible to enroll in Part C instead. Some of the most popular types of MA plans include:
- Health Maintenance Organization or HMO plans
- Medicare Savings Account or MSA plans
- Preferred Provider Organization or PPO plans
- Private Free-for-Services or PFFS plans
- Special Needs Plans or SNPs
Coverage for Medicare Part C plans
Part C Medicare Advantage plans usually include additional benefits beyond Part A and Part B. While these benefits vary from plan to plan, they can include routine vision and dental care, hearing exams and hearing aids, and prescription drug coverage. Some plans will give you coverage for health-related perks, including meal delivery services, transportation to doctor appointments, or gym memberships.
The inpatient coverage you’ll get with this plan will match Medicare Part A’s coverage options at a minimum. This includes:
- Inpatient hospital care
- Inpatient rehabilitation services
- Inpatient mental health services
- Limited home healthcare
- Limited stays in a skilled nursing facility or SNF
Again, the benefits for this plan have to match what you’d get under Original Medicare Part B at a minimum, and this includes:
- Doctor’s appointments – both routine and specialists
- Durable medical equipment like oxygen and wheelchairs
- Emergency ambulance transportation to the hospital
- Emergency room visits
- Imaging tests like x-rays and MRIs
- Laboratory tests like urinalysis and blood tests
- Mental health counseling
- Therapy, including speech, physical, and occupational
- Vaccinations for hepatitis B, the flu, and pneumococcal disease
Any additional coverage benefits will be determined and outlined by the plan you pick out. For example, some plans will cover basic hearing exams while other plants will include benefits for hearing aids too.
Medicare Advantage plan costs
The cost for your specific plan will depend on a large range of factors. The most common cost influences are:
- The Part C costs, including the monthly premiums and the deductible
- The Part B monthly premium, which your Part C plan may cover if you are eligible for both Medicare and Medicaid and you enroll in a Dual-eligible Special Needs Plan
- Your out-of-pocket expenses, including coinsurance and copayments
Should you choose a Medicare Part C plan?
You may want to consider enrolling in a Part C plan if you already get Medicare benefits under Original Medicare, but you want additional coverage. It’s also a good choice if you want the convenience of having all your coverage under one umbrella, such as prescription drug coverage and yearly hearing, dental, and vision exams. MA plans also include annual out-of-pocket maximum. Compare your options and you may find coverage that will meet your needs and preferences.
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