Medicare Part C

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Medicare Part C is the part of Medicare policy that allows private health insurance companies to provide Medicare benefits.

This is not a separate plan of its own. You can choose to get your Medicare coverage through a Medicare Advantage Plan instead of through Original Medicare. Medicare Advantage Plans must offer at least the same benefits as Original Medicare (those covered under Parts A and B) but can do so with different rules, costs, and coverage restrictions. Think HMO or PPO, like you might used to have at work.

These are the different types of Medicare Advantage Plans:

Health Maintenance Organization (HMO) plans—In most HMOs, you can
only go to doctors, other health care providers, or hospitals in the plan’s network,
except in an urgent or emergency situation. You may also need to get a referral
from your primary care doctor for tests or to see other doctors or specialists.

Preferred Provider Organization (PPO) plans—In a PPO, you pay less if you
use doctors, hospitals, and other health care providers that belong to the plan’s
network. You usually pay more if you use doctors, hospitals, and providers outside
of the network.

Private Fee-for-Service (PFFS) plans—PFFS plans are similar to Original
Medicare in that you can generally go to any doctor, other health care provider,
or hospital as long as they accept the plan’s payment terms. The plan determines
how much it will pay doctors, other health care providers, and hospitals, and how
much you must pay when you get care.

Special Needs Plans (SNPs)—SNPs provide focused and specialized health care
for specific groups of people, like those who have both Medicare and Medicaid,
live in a nursing home, or have certain chronic medical conditions.

HMO Point-of-Service (HMOPOS) plans—These are HMO plans that may allow
you to get some services out-of-network for a higher copayment or coinsurance.

Medical Savings Account (MSA) plans—These plans combine a high-deductible
health plan with a bank account. Medicare deposits money into the account
(usually less than the deductible). You can use the money to pay for your health
care services during the year. MSA plans don’t offer Medicare drug coverage. If
you want drug coverage, you have to join a Medicare Prescription Drug Plan.

What do these cost?

In addition to your Part B premium, you usually pay one monthly premium for the
services included in a Medicare Advantage Plan. Each Medicare Advantage Plan has
different premiums and costs for services.

Here is a link that you might find helpful:

Find your Medicare Advantage plan

If you have any questions, please ask in the comments below and I’ll do my best to find out for you.

 

 

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