What Is Medicare Advantage (Part C)?

November 30, 2022

Medicare Advantage, also known as part C, is the part of the Medicare system that provides coverage of certain services not covered by standard Parts A and B. Medicare advantage is crucial if you need more than what original Medicare offers.

What Does Medicare Part C Cover?

Medicare Advantage covers some basic services offered under original Medicare. Some of these include the following:

Inpatient Care

Medicare advantage normally covers inpatient care says. If you are subscribed to Medicare advantage and admitted to the hospital, your coverage must cater to all services, including general nursing care, meals, semi-private room, and medication administered. Since private hospitals offer this plan, it is upon the insurance company to decide whether the plan cover beyond what original Medicare provides.

Prescription Drugs

Another benefit of enrolling in Medicare part C is that most plans offer prescription coverage for inpatient and outpatient care. Even better, some plans come with a specialty tier for the most costly prescriptions.

Outpatient Care

Medicare part C covers some outpatient services, including preventive ones. It also covers ambulance services, clinical research, mental health, and more.

Vision, Dental, and Other Additional Benefits

Medicare advantage also offer you dental and vision perks, which original Medicare does not cover. Depending on your chosen plan, Medicare can cover tooth extractions, cleanings, fillings, and dentures, among others.

Covered vision benefits may include eye examinations, contact lenses, and glasses. Other plans also cover hearing aids. However, each plan has specific rules for determining what is covered and whether you demand a referral before receiving the services.

Some Medicare advantages provide non-medical perks such as;

  • Fall prevention aids
  • Assistance with the purchase of healthy foods
  • Companionship
  • Allowance towards over-the-counter stuff
  • Help with utility costs

Benefits Of Medicare Advantage Plans

Medicare advantage plan hosts many benefits beyond expedience and value for money. Some of them include the following:

Caters to All Benefits of Medicare A and B Plans, Without Purchasing Supplemental Insurance. It also offers additional benefits and discounts on health-related problems

It comes with lower costs than the original Medicare: All your plans are bundled under one coverage. If you are legible, Medicare advantage can help you pay for premiums (subsidies).

How Much Does Medicare Advantage Cost?

The cost may vary depending on the plan you prefer. Some plans will cover a part of your Medicare B monthly premium. But, some of this coverage comes with their deductibles.

That said, finding a Medicare part C plan that fits your budget and mostly caps your pocket costs is easier. You will pay nothing for the rest of the year if you reach the cap.

Do You Need To Enroll In Medicare Advantage Plan?

Reviewing your coverage requirements when applying for Medicare part C is vital. If your original Medicare is not enough, you might consider Medicare part C.

How To Enroll In A Medicare Advantage Plan

To join a Medicare part C plan, you need to qualify for original Medicare. Original Medicare is usually available to those over the age of 65. But it is also available to younger disabled persons.

You must also be enrolled in Medicare A and B. Plus, you need not have end-stage renal disease.

Finally, you must live in the service area covered by the plan. Thankfully, the Medicare advantage plan is available to all USA residents.

When To Enroll?

It is always a good idea to review your plan during open enrollment as this can help you from overpaying your benefits. Here is when you can enroll:

Initial Enrollment

The session allows users to join Medicare advantage three months before their 65th birthday. But enrollment is also available three months after their birthday

Fall Enrollment

Fall enrollment starts from 15th October to 7th December. The plan you select within this period is effective until 1st January.

Special Enrollment Period

This enrollment is based on your situation.

Medical Advantage Open Enrollment

Opens from 1st January to 31st March.

Do You Need A Medicare Advantage Plan?

A medical advantage plan is optional. However, the Medicare advantage plan is the best way to go if you want more than basic hospital insurance.

If you are satisfied with your current medical coverage but interested in receiving prescription drugs, Medicare part c might be your best option.

Factors To Consider When Choosing A Medicare Advantage Plan

It is crucial to understand some considerations when choosing a Medicare Advantage plan. Some of these include:

  • The monthly payment.
  • The cost of average. This includes coinsurance, deductibles, and copays.
  • If the plan formula covers your medication.
  • The additional services offered.
  • Any treatment you may demand, the plan does not cover that.
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Andi Perullo de Ledesma

I am Andi Perullo de Ledesma, a Chinese Medicine Doctor and Travel Photojournalist in Charlotte, NC. I am also wife to Lucas and mother to Joaquín. Follow us as we explore life and the world one beautiful adventure at a time.

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