Medicare Part C

The Basics of Medicare Part C

Medicare Part C, or Medicare Advantage, was created as a private health insurance alternative to Original Medicare. It is often seen as a more complete insurance plan than the combined efforts of Parts A and B. This is mainly because for a policyholder to enroll in Part C, they must first have Original Medicare. However, the perk of this section of coverage is that the main private insurance companies will offer additional benefits such as routine dental, vision, and hearing care.

The process for enrolling in Medicare Advantage can be a little lengthy at times. It is best to meet with a local licensed agent before making any decisions. As an overview, if you were to sign up for Part C, you would need to make sure you are enrolled in Original Medicare, pay the premium for Part B, select a Medicare Advantage plan, and sign up with the insurer of your choice. By sitting down with an agent from the beginning, you won’t have to worry about missing any steps or not having your questions answered. 

After you have decided to enroll in Medicare Part C, you will need to decide between an HMO plan or a PPO plan. HMO (Health Maintenance Organization) plans will typically allow you to choose a primary care doctor responsible for directing your care. However, PPO (Preferred Provider Organization) plans open up an entire network of doctors and medical facilities that you can visit without a referral. The one drawback with this type of plan is that you may be required to pay more for services by going outside of the network.

What Coverages Are Available Under Medicare Part C?

One of the biggest hesitations for people when it comes to enrolling in Medicare Part C is that they won’t be fully covered. There is a misconception that since it is a private insurance option, it will be costlier and only offer a portion of what Part A and Part B do. The truth is that anyone who does decide to partake in Medicare Part C will also be enrolled in Original Medicare and receive those benefits as well. In addition to that, policyholders will have access to certain coverages that can only be obtained through a private insurer.

Besides the added coverage on dental, vision, and hearing, beneficiaries will also notice an out-of-pocket maximum each year for Medicare Advantage. Meaning, as soon as you reach the threshold outlined in your plan, you won’t be responsible for paying for most medical services. Another cost difference between the two plans is that you could be responsible for coinsurance charges with Original Medicare. These fees could be as high as 20 percent of the total cost of service. In comparison, Medicare Part C uses copays to provide a fixed cost instead of a percentage, keeping pricing low.

Contact US

We are not connected with or endorsed by the United States government or the federal Medicare program.

John Kyle Insurance – An Agency You Can Rely On

With decades of experience, the agents at John Kyle Insurance are happy to sit down with you and discuss your long-term goals. From there, they can assist you in making the best insurance decision for you and your family. To get started, give us a call today at (440) 230-1223.