What Is Medicare Part C? What You Need to Know

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Medicare Part C is another name for Medicare Advantage, which is an all-in-one alternative to Original Medicare.

You’ll sometimes see references to Medicare Part C. This is just another name for Medicare Advantage, which is an all-in-one alternative to Original Medicare — meaning it replaces Medicare Part A (hospital coverage), Medicare Part B (medical insurance) and often Medicare Part D (drug coverage).

Private companies can offer Medicare Part C plans that have been approved for Medicare. Most plans provide benefits that aren’t covered under Original Medicare, such as dental, hearing and vision coverage. You may also be eligible for coverage for gym memberships, transportation to medical appointments, and over-the counter drugs. Certain chronic conditions may also be covered by some plans.

Medicare Part C is available in many types. They are similar to non-Medicare insurance. There are different requirements for finding providers. For example, an HMO plan requires that you only see in-network providers unless you have an urgent medical condition. You will need a referral to a specialist to be seen. A PPO plan allows you to see both out-of-network and in-network providers. However, it is more expensive to go outside of the network.

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The federal and state laws that govern Medicare Part C companies must adhere to. However, out-of-pocket expenses and rules for accessing services can differ between plans. Companies have the ability to change these aspects year to year. Before you choose the right plan for you, compare their rules, benefits, and costs.

Advantages of Medicare Part C

  • Instead of Medicare Parts A, B, and D separately, all your coverage will be bundled under one plan.
  • You may also be eligible for additional benefits such as hearing, vision, and dental coverage.
  • Original Medicare may have lower out-of-pocket expenses.
  • All rights and protections are still available to you under Medicare.

Medicare Part C’s Disadvantages

  • You may have a smaller list of providers in-network than Original Medicare.
  • Depending on the type of plan you have, you may need authorizations or referrals to access certain services.
  • If you travel beyond your coverage area, your plan may not cover it.

You must have Original Medicare Part A or Part B coverage to sign up for Medicare Advantage Plans. Use Medicare’s Plan Finder to find and compare plans in your area.

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