What Does Medicare Part C Cover?
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What Does Medicare Part C Cover?
Medicare Advantage plans allow you to receive your benefits from a private insurance company approved by Medicare. If you have Medicare Part A and Medicare Part B, you can receive your benefits from a Medicare Advantage plan. Medicare Advantage plans are not supplemental insurance, but rather health insurance plans of their own. Medicare Advantage can also include prescription drug coverage in addition to vision, hearing, and dental. In most cases, you can join even if you have been diagnosed with a pre-existing condition, except for End-Stage Renal Disease. Medicare Advantage plans must follow guidelines established by Medicare but they can vary in terms of costs and rules.
Payments and Enrollment?
With a Medicare Advantage plan, you may be able to lower your out-of-pocket costs. Some Medicare Advantage plans have lower co-payments than Medicare Parts A and B, but are also limited to certain service areas and often involve networks. You may have to pay a premium each month due to the extra benefits you may receive from the plan. You can enroll in a Medicare Advantage Plan during your Initial Enrollment Period, the Medicare Advantage and Prescription Drug Plan Annual Enrollment Period and there are also Special Enrollment Periods for certain situations. The amount that you pay yourself varies from plan to plan, so it is necessary to compare plans in order to find the plan most suitable to your needs. You can enroll in plans by paper, telephone or an online application.
What are my Options?
Health Maintenance Organization (HMO)
HMO plans are required to cover both Part A and Part B health care, but can also offer additional benefits. You will only be able to visit physicians and hospitals that are within the HMO network unless there is an emergency. However, HMOs can lower costs, making them (in some cases) less expensive than Medicare Parts A and B.
Preferred Provider Organizations (PPOs)
PPOs allow you to use doctors, hospitals, and specialists within the PPO network. However, you are permitted to use health providers outside of the network at an additional cost to you without a referral.
Private Fee-for-Service (PFFS)
With a PFFS plan, you are able to use any doctor or specialist, so long as they accept the terms, fees, and conditions of the PFFS. The plan chooses how much it will pay for the services, and you can spend more or less on PFFS plans than Medicare Parts A and B.
Medicare Medical Savings Account (MSA)
An MSA combines a medical savings account with a high deductible. Medicare gives the plan an amount of money each year for your health care and the plan deposits this money into your account. You can use this money to pay for health care costs, even if they’re not covered by Medicare. If you use it for Medicare Part A and Medicare Part B services, you can count this towards your deductible. If you have used the money provided but have additional health care costs, you’ll have to pay for the Medicare-covered services out-of-pocket. After you reach your deductible, the plan will cover Medicare-covered services.
Are there any risks and what if I’m not satisfied?
If you have a Medicare Advantage Plan, you can’t have a Medigap policy, because Medicare Advantage Plans cover many of the same benefits. With a Medicare Advantage Plan, you are still in the Medicare program and can still get complete Part A and Part B coverage through the plan. If the plan opts to end its involvement with Medicare, you will need to choose another plan or enroll in Medicare Parts A and B.
What Our Customer Says
I’m a young lawyer and had no idea how Medicare worked. I was getting so many calls and was overwhelmed until a friend told me about Medicare Service. My experience was friendly, patient, and caring. They helped me pick a Medicare Advantage plan that didn’t cost me a dime. I never felt pressured—just supported!
Running a restaurant means every minute counts, so I needed a Medicare team that could keep things simple. Medicare Service walked me through everything, answered all my questions, and helped me find a plan that actually fits my lifestyle. I finally feel confident about my coverage. What really stood out was how patient and genuine.
The enrollment process was so easy. I wasn’t sure what plan was right for me, but I got honest advice, and everything changed. My agent took time to listen to my story, explained things in a way I understood, and helped me find a plan that covered my doctors and prescriptions. Best of all, it didn’t cost me a dime. I now recommend them for Medicare coverage.
I’m a young lawyer and had no idea how Medicare worked. I was getting so many calls and was overwhelmed until a friend told me about Medicare Service. My experience was friendly, patient, and caring. They helped me pick a Medicare Advantage plan that didn’t cost me a dime. I never felt pressured—just supported!
Switching from my employer insurance to Medicare felt like jumping into the unknown. Thankfully, Medicare Service made it painless. They took the time to understand my situation and explained all my options clearly. They even checked that my heart specialist and medications were covered. I’ve already recommended them to my sister. Excellent service!
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Frequently Asked Questions
Do I have to pay for your services?
No, our help is 100% free. We’re paid by the insurance companies if you enroll in a plan, not by you. There’s no extra cost for working with us.
When can I enroll in Medicare?
Most people enroll around age 65 during their Initial Enrollment Period. There are also specific enrollment windows each year, such as the Annual Enrollment Period (October 15 – December 7), when you can make changes to your coverage.
What’s the difference between Medicare Part A, B, C, and D?
Medicare Part A: Hospital coverage (inpatient stays, skilled nursing, hospice, some home health).
Medicare Part B: Medical coverage (doctor visits, outpatient care, preventive services).
Medicare Part C: Medicare Advantage plans offered by private companies, combining Parts A & B and often including extra benefits like dental, vision, or prescriptions.
Medicare Part D: Prescription drug coverage.
Can I change my Medicare plan later?
Yes. You can make changes during the Annual Enrollment Period each year, and sometimes during Special Enrollment Periods if you qualify (for example, moving to a new area or losing other coverage).
Will I lose my doctor if I switch plans?
It depends on the plan you choose. Some Medicare Advantage and Part D plans have provider networks. Before switching, we’ll help you check whether your doctor is included in the plan’s network so you can keep your preferred providers.