PART C = MEDICARE ADVANTAGE

Part C is another name for what most people call a Medicare Advantage Plan. Rather than running medical claims through Medicare first and then a Medigap (Medicare Supplement) plan and then purchasing a stand-alone Part D prescription drug plan, you would use the Medicare Advantage plan to file all medical and prescription drug claims. You don’t need your Original Medicare card in this case (just file it away in a safe place).

Part C (Medicare Advantage) plans typically combine Parts A, B and D in one plan; though, some Medicare Advantage plans are available without Part D prescription drug coverage (i.e. when you already have creditable prescription drug coverage through another source, such as the VA).

Medicare Advantage plans often include additional coverages such as vision, hearing care, dental and even gym memberships.

A Medicare Advantage plan may resemble a group plan a you are used to from a previous employer.  Often times, it will be an HMO, or a Networked group of doctors and medical practitioners.  You will still be able to utilize the plan when out of your coverage area for covered Emergency and Urgent care services.  However, it’s important to bear in mind, your Primary Care Physician and main network of medical specialists will be within the Network.  Additional perks of Medicare Advantage Plans may include Over the Counter credits which are added to your account quarterly.

Same as with a Medicare Supplement Plan, you will still pay your Part B premium with a Medicare Advantage Plan ($164.90 for 2023*).  Unlike Medicare Supplement plans, the actual plan for your Medicare Advantage Plans often have zero and/or low-cost premium options available.  This means you are fulfilling all of the Medicare coverage requirements for Part A, Part B and Part D thus enjoying medical coverage and avoiding late penalties.

*Most beneficiaries pay the base premium of $164.90 for 2023 (the amount can adjust annually).  An IRMAA  (Income-Related Monthly Adjustment Amount) applies to high-income earners, and they will pay a higher premium.