There are four parts of Medicare. In general:

  • Inpatient hospital coverage = Medicare Part A
  • Outpatient medical coverage = Medicare Part B
  •  Alternative benefit form to Original Medicare that offers extra benefits = Medicare Part C
  • Prescription drug coverage =Medicare Part D

Today, we will be looking further into Medicare Part C.

Medicare Part C is also known as Medicare Advantage. It’s an alternative benefit to Original Medicare. Medicare Advantage may include prescription drug coverage, as well as other extra benefits. It is offered through private insurance companies, so you don’t enroll in it at the Social Security office or website.

What does Medicare Part C cover?

Medicare Part C plans are private Medicare plans which pay instead of Medicare. This plan resembles group insurance benefits, similar to what you may have had through former employers. Generally, there is a local network of providers that you will use. You pay copays for many routine services like doctor’s visits, lab-work, ambulance, surgeries, hospital stays, urgent care and more.

Medicare Part C covers the same services as Part A and B (both hospital and outpatient benefits.) However, instead of paying deductibles and 20% of your medical services, you pay the plan’s copays.

Medicare Part C is now better known as Medicare Advantage.  This plan acts as a package where you will have Part A, Part B and usually Part D together in one plan. You will have one ID card that you use at hospital, doctor’s office and pharmacy.

Who is eligible for Medicare Part C?

To be eligible for Medicare Part C, or Medicare Advantage, you must first be enrolled in Medicare Part A and B and live in the service’s area.  You can enroll if you wish to get your benefits through a private insurance company instead of Original Medicare.

Who is eligible for Medicare Part C? Any Medicare beneficiary, regardless of age, can purchase a plan if they meet these criteria:

  • You are enrolled in both Medicare Part A and B. Many people make the mistake of trying to drop Part B once they enroll in Medicare Part C. If you drop Part B, you will immediately be kicked out of your Part C plan. Simply put, make sure you keep Part A and Part B.
  • You live in the plan’s service area. This Medicare Part C eligibility will be based on the address you have on file with Social Security and you must choose a plan that operates in that same county in which you reside. Some plans will be specific to only one or two counties, while others might cover the entire state.
  • You don’t have End-Stage Renal Disease. This is only medical question that will be asked on your Part C application.

Remember, Medicare Advantage plans have election periods, so you can only enroll during your Initial Enrollment Period or the Annual Election Period in the fall.

How do I enroll for Medicare Part C?

Medicare Part C  is not a program that you enroll in at Social Security. You will need to call insurance providers instead. Medicare Part C plans provide you an alternative to traditional Medicare. They are optional, so not everyone needs Part C.

When do I enroll for Medicare Part C?

You can enroll in a Medicare Advantage plan when you first get Medicare Part B. You can also enroll during the annual election period each fall, which is from October 15 to December 7. Your benefits begin January 1.

How much does Medicare Part C cost?

Medicare Part C premiums vary by plan. Be sure to shop around for the best deal.