Senior Health Information and Insurance Education

Part C Coverage

Part C plans are sold by private insurance companies and are commonly known as Medicare Advantage or Medicare Health Plans.

What will it cost?

  • Part C plans may require a monthly premium, as costs vary. Most people pay between $0-$200 per month.
  • You may have copays and other out-of-pocket costs.
  • Additionally, you must pay your Part B premium.

What does it cover?

  • Part C is an alternative to Medicare Parts A and B. Plans cover all services Original Medicare Parts A and B cover.
    • Private insurance companies are subsidized through Medicare to manage the financial and administrative duties for their enrollees' coverage of Part A and B.
    • When you enroll, your provider will bill the insurance company instead of Original Medicare.
    • The plan determines the costs and copayments for the services you receive. They are usually different from Medicare's costs.
  • May have limited providers in your area, ask your provider if they work with the plan you are considering.
  • Most Part C plans include prescription drug coverage (Part D).
  • Part C may provide additional coverage, such as vision and dental, not covered by Part A and Part B.

What plans are available for me to explore?

Visit Medicare.gov's Plan Finder Tool and enter your zip code or do a Personalized Search. Follow the steps and when you get to Step 4 choose "Medicare Health Plans (with or without drug coverage)" to get a list for your area. Once you discover what is available in your county use the tools on this page to assist you in determining if any of those options will work well for you.

Tools to use when you are exploring your plan options.

SHIINE recommends you look into all the plans you are considering before enrolling to determine what is the best fit for your situation. This will require some research and probably a phone call to the plan and your health care providers, here are some tools to help you:
Exploring PPO, PFFS and Cost Plans

When can I enroll?

How can I enroll?

  • Call the plan directly
  • Call 1-800-MEDICARE (800.633.4227) or
  • Going to Medicare.gov


 
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