A Basic Guide To Medicare Advantage Plans (Part C)

By B. Loughead

 

The coverages of Medicare Parts A and B as well as additional benefits are combined under Medicare Advantage plans (Part C). Most of these plans will also include prescription drug coverage or Medicare Part D. If you want to enroll in one of the Advantage plans that are available through private companies, you can do so provided that you already have or can qualify for regular Medicare coverage. You won't need all three of these coverages nor will you have the need for any type of Medigap coverage if you enroll in Plan C.

The Differences Between Original Medicare and Medicare Advantage Plans

Although everything that Medicare usually covers is covered by a Medicare Advantage plan, there are some differences between them to be aware of. Most of the time, the difference is in the amount you pay for health care out-of-pocket. Some of those differences include:

• co-insurance or paying a different percentage share of your medical bills
• co-pays
• deductibles
• Network of providers available
• In Network vs. Out of Network

Additionally, emergency medical and urgent care is included in Medicare Advantage plans (Part C). In some instances, routine dental, routine vision, and/or wellness programs may also be covered by some plans. Most will include Part D coverage. However, Part C coverage does not include any hospice care, even with a Medicare Advantage plan, as it is still covered under Medicare.

The Different Types Of Medicare Advantage Part C Plans

In order to determine which type of Part C plan will facilitate your needs, you need to review the different types of plans that are currently available. There are several different plans including the following:

HMO - Health Maintenance Organization Plan
MSA - Medical Savings Account Plan
PFFS - Private Fee-for-Service Plan
POS - Point of Service Plan
PPO - Preferred Provider Organization Plan
SNP - Special Needs Plans

Information regarding these six different types of plan is available online simply by using the abbreviation or what it stands for as the keywords for your Google search.

Part C Enrollment

In closing, the enrollment process for Medicare Advantage plans (Part C) will differ based on which private insurance carrier you select. However, enrollment periods are identical regardless. Enrollment is allowed once you are eligible for Medicare, but there is a 7-month waiting period that begins 90 days prior to your 65th birthday and continues for 120 days afterwards. Finally, if you are less than 65 years of age and are receiving SSDI (Social Security Disability Insurance), you will qualify once you have been receiving SSDI for 2 years and 1 month.

Summit Medigap is an independent insurance agency that specializes in Medicare supplement insurance. We make Medicare seem easy™. For more information about Medicare supplement insurance visit http://www.SummitMedigap.com/ or call us at 1-888-40-Summit (888-407-8664).