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Medicare Advantage Part C


What Is Medicare Part C?

Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are an “all in one” alternative to Original Medicare.

Medical Advantage Part C or MA are offered by private companies approved by Medicare.

If you join a Medicare Advantage Plan, you still have Medicare.

These “bundled” plans include  Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance), and usually Medicare prescription drug (Part D).

Covered services in Medicare Advantage Plans

Medicare Advantage Plans cover all Medicare services. 

Some Medicare Advantage Plans also offer extra coverage, like vision, hearing and dental coverage.  

Rules for Medicare Advantage Plans

Rules for Medicare

Medicare pays a fixed amount for your care each month to the companies offering Medicare Advantage Plans. These companies must follow rules set by Medicare. Each Medicare Advantage Plan can charge different out-of-pocket costs. They can also have different rules for how you get services, like:

  • Whether you need a referral to see a specialist
  • If you have to go to doctors, facilities, or suppliers that belong to the plan for non-emergency or non-urgent care

These rules can change each year.

Costs for Medicare Advantage Plans

What you pay in a Medicare Advantage Plan depends on several factors. All plans include a cap on your out of pocket costs.

Drug coverage in Medicare Advantage Plans

Most Medicare Advantage Plans include prescription drug coverage (Part D). You can join a separate Medicare Prescription Drug Plan with certain types of plans that:

  • Can’t offer drug coverage (like Medicare Medical Savings Account plans)
  • Choose not to offer drug coverage (like some Private Fee-for-Service plans)

You’ll be disenrolled from your Medicare Advantage Plan and returned to Original Medicare if both of these apply:

  • You’re in a Medicare Advantage HMO or PPO.
  • You join a separate Medicare Prescription Drug Plan.

How Medicare Supplement Insurance (Medigap) policies work
with Medicare Advantage Plans

Medigap policies can’t work with Medicare Advantage Plans.

(Information provided via Medicare,gov) a federal government website owned and managed by the U.S. Center for Medicare & Medicaid Services)