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Medicare Part C is commonly called Medicare Advantage. It combines the coverage of Medicare Parts A and B. This includes hospital coverage from Part A and general medical coverage from Part B. It may also include other benefits, such as dental and vision.
What does Part C cover?
Medicare Advantage coverage features a wide range of benefits. You can add some of these by combining Part C with other parts of Medicare. An example of that is combining a Medicare Advantage plan with Part D to get prescription drug coverage. Here are some other common benefits you can get with Part C:
- Routine dental care
- Routine vision care
- Hearing tests and aids
- Over-the-counter coverage
Original Medicare vs. Medicare Advantage
There are two key differences between Original Medicare and Medicare Advantage. The first is where the coverage comes from. Original Medicare comes from the federal government, while Medicare Advantage is from private insurance companies. The second difference is Medicare benefits. Medicare Advantage offers all the coverage you get with Original Medicare, with other benefits added.
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Medicare Advantage plan types
There are many Medicare Advantage plans to choose from:
- HMO plans — HMO stands for health maintenance organization. In these plans, you usually choose a primary care provider from a list of in-network providers. You have limited out-of-network benefits.
- HMO-POS plans — HMO-POS stands for health maintenance organization with a point of service option. In these plans, you choose an in-network primary care provider. While medical care must be in network, you can find out-of-network dental care. You may pay more for this care.
- PPO plans — PPO stands for preferred provider organization. In these plans, you can select any provider who accepts Medicare along with the terms of your specific plan. You generally pay less for using providers in your plan’s network.
- SNPs — SNP stands for Special Needs Plans. These plans are for people with certain health conditions or other care needs. If you have a chronic condition, qualify for both Medicare and Medicaid or have lived in a specialized care facility for over 90 days, you may qualify for an SNP.
How to enroll
There are several enrollment periods for Medicare Advantage:
- Initial Enrollment Period (IEP) — Your Initial Enrollment Period includes the 3 months before you turn 65, the month you turn 65, and the 3 months after. If you have a qualifying disease or disability, this period includes the 3 months before your diagnosis, the month of your diagnosis, and three months after.
- Annual Enrollment Period (AEP) — This period lasts from October 15 to December 7 every year. During this time, you can switch to a Medicare Advantage plan from Original Medicare or switch Medicare Advantage plans.
- Special Enrollment Period (SEP) — This period is for people in special situations. Those situations include things like ending/losing employer medical coverage and moving outside your current plan’s service area. The Special Enrollment Period may be different depending on your situation.
- Medicare Advantage Open Enrollment Period (OEP) — This period runs from January 1 to March 31 each year. If you have a Medicare Advantage plan, you can make a one-time switch to a different Medicare Advantage plan or to Original Medicare.
Is this plan right for me?
If you are eligible for Medicare, you can enroll in Medicare Advantage. Choosing your coverage can be a difficult decision, but we’re here to help.