Medicare Part C - Medicare Advantage
A Medicare Advantage Plan (like an HMO or PPO) 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 (Hospital Insurance) and Part B (Medical Insurance) 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 (Part D).
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 (like whether you need a referral to see a specialist or if you have to go to only doctors, facilities, or suppliers that belong to the plan for non‑emergency or non-urgent care). These rules can change each year.
Medicare offers different types of health insurance plans. The three types of Medicare health plans are:
– Original Medicare (Parts A and B)
– Medicare Advantage Plans (Part C)
– Medicare Prescription Drug Plans (Part D)
Original Medicare is the traditional government-provided health insurance. It’s a fee-for-service plan, which means you can go to any doctor, hospital, or other provider that accept Medicare patients. However, Original Medicare doesn’t cover everything. You may have to pay some costs out of your own pockets, such as for prescription drugs and routine dental care.
A Medicare Advantage Plan is a private health plan that replaces Original Medicare. These plans must offer all the same benefits as Original Medicare, but they may also offer extra benefits, such as vision, hearing, dental, and health, and wellness programs. Most include Medicare prescription drug coverage (Part D).
Medicare Advantage Plans can be HMOs or PPOs. An HMO (Health Maintenance Organization) is a type of Medicare Advantage Plan that usually requires you to use doctors, hospitals, and other providers that belong to the plan’s network. If you want to go outside of the network for care, you may have to pay more. A PPO (Preferred Provider Organization) is a type of Medicare Advantage Plan that gives you more flexibility to go outside of the plan’s network, but usually at a higher cost.