MEDICARE ADVANTAGE (PART C)
Medicare Advantage Plans, usually referred to as Part C, are offered by private companies. These plans combine Part A and Part B into one plan. There are many different types of Medicare Advantage plans, however, most include additional benefits that are not included in Original Medicare, such as prescription drug coverage. These plans usually have low monthly premiums with a maximum out-of-pocket or safety net, that are met with your co-payments.
For example, a plan could have a $5000 safety net, which means that is the maximum you will pay out of pocket for your hospital and medical services for that plan year. Most plans have service areas, where you are limited to a geographic boundary of where you can seek medical services. They do include nationwide coverage for emergency room, urgent care, and renal dialysis. You will still be in Medicare and continue to pay your Part B premium, however, Medicare will not be paying your claims, the Medicare Advantage carrier will.
There are many plans available, but most usually have a network of doctors, and hospitals. This type of plan is called a coordinated care plan, where the network of doctors and hospitals work together to provide you care. In most cases, if you see an out-of -network doctor, you will pay more or you may have to pay all the out-of-network costs. Some of these types of plans include a Health Maintenance Organization (HMO), Point of Service (POS) and Preferred Provider Organization (PPO). Some of these plans require you to select a primary care physician when you enroll in the plan, and also may require you to get referrals for specialists. There are many Medicare Advantage plans in our area that all offer different plan benefits. Contact your local broker to discuss the plan that is right for you.