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What Are Medicare Part C Benefits

How Many People Have Medicare Advantage Plans

Medicare Advantage Part C

More than 28 million older adults were enrolled in Medicare Advantage coverage in 2022, representing 45% of all Medicare beneficiariesMedicare Advantage 2022 Spotlight: First Look. Kaiser Family Foundation. Accessed 8/29/2022. . And when shopping, they had more plan options than ever before. The average enrollee had access to about 39 different Medicare Advantage plans in 2022, based on factors like their location and level of desired coverage, according to KFFMedicare Advantage 2022 Spotlight: First Look. Kaiser Family Foundation. Accessed 8/29/2022. .

Medicare Part C Vs Other Plans

Medicare Part C plans and traditional Medicare policies are different. Part C bundles services together, and depending on the plan, may offer more services than traditional Medicare, including dental, vision, and hearing care.

People should check theirindividual plan to see what it covers on top of traditional Medicare. Companiesoffer many different plans.

  • If a person uses traditional Medicare, they pay Medicare directly, and Medicare pays out for their services.
  • Medicare Part B: A person pays their Medicare Part B premium directly to the government.
  • Medicare Part C: People with Part C pay a private insurance company.
  • Medicare Part D: Medicare Part D is the traditional portion of Medicare that pays for prescription drug coverage. A person can select from several plans and pay a monthly premium directly to the government.
  • Medigap: Medigap insurance can help a person pay for co-payments and deductibles, as well as other out-of-pocket expenses.

Some people prefer thefreedom of choosing their own providers and specialists that can come withtraditional Medicare.

What Is The Annual Election Period

The annual election period is the interval in which Medicare beneficiaries can make changes to their coverage. It is also called the annual enrollment period or Medicare open enrollment.

The AEP dates run from October 15 through December 7. During this time, people can change between Original Medicare and Medicare Advantage plans, or between the various Medicare Advantage plans.

Individuals may also change from one Medicare Part D plan to another or enroll in a Part D plan if they did not do so when they were first eligible.

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Tips On Choosing A Medicare Advantage Plan

  • Assess your needs and budget. Example: Would you prefer a plan with in-network care to help save money on premiums?
  • Compare plans in your areabenefits and premiums are different for each plan.
  • Check whether healthcare providers you use are in the plans service area and network.
  • Make sure your prescriptions are covered on the plans formulary if drug coverage is included.
  • Understand how the plan works before you enroll.
  • Review your coverage each year to decide whether you want to change plans.

Read more Medicare tips for choosing a plan.

What Does A Medicare Advantage Plan Cost

How Medicare Advantage (Part C) Enrollment Works

Depending on your Medicare Advantage plan, the costs you pay out-of-pocket can vary:

  • You may pay a deductible, a certain amount you must meet before your plan begins to pay.
  • There may be copays for doctor visitsthis is a flat fee usually due at the time of the visit.
  • You may have to pay a share for lab services and medical equipment.
  • You will pay a monthly plan premium if there is one.
  • You will continue to pay the Original Medicare Part B monthly premium, as well.
  • Additional coinsurance or copays if you see providers outside your plan network.

To help control your costs, make sure you understand the terms of your plan and the out-of-pocket costs you may be required to pay.

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What Is Medicare Part C

A Medicare Advantage Plan is another Medicare health plan choice you may have as part of Medicare. Medicare Advantage Plans, sometimes called Part C or MA Plans, are offered by private companies approved by Medicare.

If you join a Medicare Advantage Plan, the plan will provide all of your Part A and Part B coverage. Medicare Advantage Plans may offer extra coverage, such as vision, hearing, dental, and/or health and wellness programs. Most include Medicare prescription drug coverage .

Medicare pays a fixed amount for your care every month to the companies offering Medicare Advantage Plans. These companies must follow rules set by Medicare. However, each Medicare Advantage Plan can charge different out-of-pocket costs and have different rules for how you get services . These rules can change each year.

Medicare Advantage Enrollment Dates

Initial enrollment period When you first become eligible for Medicare Your initial Medicare enrollment period lasts for seven months, starting three months before you turn 65 and ending three months after the month you turn 65.
Medicare annual enrollment period You can join, switch, or drop a plan. This includes Medicare Advantage and Medicare Part D plans.
Medicare Advantage open enrollment period If you’re enrolled in a Medicare Advantage plan, you can switch to a different Medicare Advantage plan or to Original Medicare . You can only switch once during each open enrollment period.
Special enrollment periods During certain special circumstances and changes in your life4 Examples include moving to a skilled nursing facility or long-term care hospital.Rules about when you can make changes are different for each SEP.

From the pros: Avoid costly late enrollment penalties by following our valuable Medicare enrollment guide!

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Plans Provide Additional Coverage

Part C plans frequently include benefits in addition to what Original Medicare offers. This can include more preventive care, auxiliary health care services and discount programs. As a part of their unified coverage, most plans also include prescription drug coverage, adding in the benefits that would normally be offered through a separate Part D plan.

Medical service

Cost-sharing benefits on top of Part A and B

The Part B Premium Reduction Plan Will Pay Some Or All Of Your Monthly Premium But Its Only Available With Certain Medicare Advantage Plans

Medicare Advantage Plans â Part C: Medicare Enlightenment Series

Even though itâs not an official Medicare program, the Medicare giveback benefit, or Part B premium reduction plan, is offered by some Medicare Advantage plans. This program is designed to cover some or all of your Part B monthly premium .

However, not all plans offer this benefit, and not all plans are available in all zip codes. Read on for more information about the Part B giveback program, who qualifies, and how to find the best plan for you.

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How Do You Enroll In A Medicare Advantage Plan

If you want to enroll in a Medicare Advantage plan, you must:

  • Be eligible for Medicare
  • Be enrolled in both Medicare Part A and Medicare Part B
  • Live within the plans service area
  • Not have end-stage renal disease

Want more information about enrollment? Visit Medicare Part C Eligibility and Enrollment Information

Whats Covered Under Part C

Part C covers all the benefits of Original Medicare , plus additional benefits that Original Medicare doesnt cover and the option to include prescription drug coverage. Many people choose to add Part C because it provides more complete coverage than just Original Medicare.

  • All the benefits of Original Medicare
  • Routine eye exams
  • Prescription drug coverage

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Explore Our Plans And Policies

Medicare Advantage Policy Disclaimers

All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation. The Cigna name, logos, and other Cigna marks are owned by Cigna Intellectual Property, Inc. All clinical products and services of the LivingWell Health Centers are either provided by or through clinicians contracted with HealthSpring Life & Health Insurance Company, Inc., HealthSpring of Florida, Inc., Bravo Health Mid-Atlantic, Inc., and Bravo Health Pennsylvania, Inc. or employees leased by HS Clinical Services, PC, Bravo Advanced Care Center, PC , Bravo Advanced Care Center, PC and not by Cigna Corporation. The Cigna name, logos, and other Cigna marks are owned by Cigna Intellectual Property, Inc. All pictures are used for illustrative purposes only.

Cigna contracts with Medicare to offer Medicare Advantage HMO and PPO plans and Part D Prescription Drug Plans in select states, and with select State Medicaid programs. Enrollment in Cigna depends on contract renewal.

Medicare Supplement Policy Disclaimers

Medicare Supplement website content not approved for use in: Oregon and Texas.

AN OUTLINE OF COVERAGE IS AVAILABLE UPON REQUEST. We’ll provide an outline of coverage to all persons at the time the application is presented.

American Retirement Life Insurance Company, Cigna National Health Insurance Company and Loyal American Life Insurance Company do not issue policies in New Mexico.

Exclusions and Limitations:

What Is A Special Election Period

Most Popular Medicare Supplemental Insurance Plans: Medicare Supplement C

A special election period or special enrollment period is when someone can change their Medicare Advantage coverage outside of the official AEP or IEP.

When certain qualifying events happen, such as moving to a new area or losing existing insurance coverage, this triggers an SEP.

There are various rules and approved reasons that affect what changes an individual can make to their Medicare coverage.

The government has a calculator that people can use to determine whether they are eligible for Medicare coverage and, if so, the likely premium.

People can use the calculator at Medicare.gov.

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Medicare Advantage Vs Medicare Supplement Plan

When Original Medicare misses out-of-pocket expenses like copays, co-insurance and deductibles, Medigap will pay most of whats left in the gap.

However, bundled benefits make Medicare Advantage plans a popular choice. Most Medicare Advantage plans bundle Part A and Part B with Part D and extras benefits like vision, dental, and hearing.

Keep in mind, local/regional networks limit where you can use your Medicare Advantage plan. So if you like to travel around the U.S. during the year, Original Medicare with a Medigap plan may be the right choice for you.

One thing to keep in mind about a Medigap and Medicare Advantage plan:

You cannot enroll in both plans. You must choose Original Medicare and add Medigap coverage or instead choose a Medicare Advantage plan.

Are you eligible for cost-saving Medicare subsidies?

Lets take a look at Part C cost information to consider:

  • There are several options when choosing a Medicare Advantage plan. Selecting the right plan for your needs is critical.
  • Typically, Medicare Advantage plans have a monthly premium but some Medicare Advantage Plans do not have premiums.

Dont forget general healthcare costsTRUSTED & VERIFIEDhealthcare.gov when you select your plan. Typical cost factors include:

How Much Does A Medicare Part C Plan Cost

As usual, Medicare plan costs can vary person to person. However, if you are feeling as though a Medicare Advantage plan is right for you, you should thoroughly consider your financial position. Advantage plans tend to be a great option for Medicare-eligible individuals who are looking to save money each month, but tend to have lower coverage needs. Typically with any health insurance plan, the lower the premium, the higher the deductible. Since an Advantage plan would entail a $0 premium, you could be paying more, especially factoring in aspects like prescription costs.Members with continuing curiosity about what they could pay with an Advantage plan are also encouraged to utilize our Cost Estimator tool.

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Am I Eligible For Medicare Part C And How Do I Qualify

If a Part C plan sounds like the right thing for you, you can follow the normal application process. However, the normal Medicare enrollment factors still apply:

  • You must have both Part A and B Medicare to enroll.
  • You must be a permanent Michigan resident and reside in our service area for at least six months of the year.
  • You cant be denied for pre-existing conditions unless youve been diagnosed with end stage renal disease .

When Can I Enroll In Medicare Advantage

Medicare Part C

Medicare requires that you enroll in, disenroll from, or make changes to your Medicare Advantage plan only during pre-determined enrollment periods.

If you are enrolling for the first time, you may be able to join a plan during your Initial Enrollment Period, which occurs around your 65th birthday, or around your 24th month of disability .

You also may be able to join or switch plans during the Annual Election Period , which runs from October 15 to December 7 every year.

There are also Special Enrollment Periods that may let you join a plan outside of the main enrollment periods, depending on your circumstances.

Qualifying circumstances for a Medicare Special Enrollment Period include, but aren’t limited to:

  • Moving outside of your current plan’s coverage area
  • Moving to an area where additional coverage options exist
  • Losing employer coverage

More info: How to apply for a Medicare Advantage plan

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Other Types Of Medicare Advantage Plans

If you want more freedom in health care providers or payment options, there are two other types of Medicare Advantage plans to consider.

Private Fee-For-Service plans

PFFS plans may or may not have a doctor/provider network, but cover any doctor or provider who accepts Medicare. If the plan doesn’t include prescription drug coverage, you can also enroll in a stand-alone Part D plan separately.

Medical Savings Account plans

MSA plans combine a high-deductible health plan with a special savings account. Medicare deposits funds that are withdrawn tax free to pay for qualified health care services. You can see any doctor or provider you choose. MSA plans don’t cover prescription drugs, but you can enroll in a stand-alone Part D plan separately.

Not all plans are available in all areas.

Types Of Medicare Advantage Plans

There are different types of Medicare Advantage plans available. Your choices might include:

  • Health Maintenance Organization plans
  • Preferred Provider Organization plans
  • Special Needs plans
  • Private Fee-for-Service plans

Some plans may require you to see doctors within their network in order to qualify for coverage. Others might let you see providers outside the network, but the coverage may be less. If you choose one of these plans, make sure your doctor is in the network before you enroll.

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What Else Do You Pay For When You Have Medicare Part C

When considering your Medicare expenses, there are two costs to consider in addition to your monthly premium.

  • Add-on insurance policies

    Coverage for dental, vision or hearing varies. These benefits may be included in a Part C plan, which means you’d have no additional cost. You could also have to pay a fee to add this coverage or purchase a stand-alone plan.

    A cheaper policy is less likely to include these benefits, and the extra costs can add up. For example, in addition to a $15 Part C plan, you could pay an extra $25 per month for dental coverage and $15 for vision, bringing your total to $55 per month. If you want these coverages, compare the total cost of a cheap policy with add-ons to a more comprehensive policy with a higher price. You may pay less overall by choosing a bundled plan that includes dental and vision coverage.

  • Enrolling In Medicare Part C

    About Medicare and Medicare Advantage

    There are different times of the year when you can enroll in a Medicare Part C plan. The first time is during your Initial Enrollment Period . This is the period when you first become eligible for Medicare. This enrollment period begins three months before the month you turn 65. It includes your birthday month and the three months following. For those seven months, you can enroll in a Medicare Part C plan or a Prescription Drug plan.

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    How Can I Enroll In Medicare Part C

    In order to enroll or switch to a Medicare Advantage plan, you must first be enrolled in Medicare Part A and Part B through Social Security. Then you should contact a private insurance company to enroll in Medicare Advantage, or you can enroll by mail after completing paper enrollment forms. You can also contact a licensed insurance agent with GoHealth, who will walk you through the enrollment process and answer any questions about finding the right plan for you. Learn more about how to navigate Medicare Part C enrollment.

    What extra benefits and savings do you qualify for?

    What Is Medicare Part C Special Enrollment Period

    Certain life events trigger special enrollment periods when you can switch from one Part C plan to another or sign up for Medicare Part C coverage for the first time. There are several life events that count as SEPs for Medicare Advantage. Many of these SEPs also apply to Medicare Part D prescription drug plans. Some of these SEPs include:

    • Plan not renewing or reducing its service area: You can enroll in another MA plan starting December 8 and ending the last day of February.
    • Medicare ending the plans contract: You can switch to another MA plan starting the 2 months before the contract terminates and ending 1 full month after the contract terminates.
    • Losing eligibility for Medicaid: If you receive a notice that you will no longer be eligible for Medicaid benefits for the current plan year, you will have 2 full months after receiving the notice to join an MA plan. If you will not be eligible for Medicaid the following year, you can enroll in an MA plan between January 1 and March 31 .
    • Living in a Part C or Part D service area with an overall 5-star quality rating: You can join an MA plan with an overall 5-star quality rating one time between December 8 and November 30.

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