Medicare Part C:  Medicare Advantage Plans

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Published on
22 January 2021

One of the options a Medicare beneficiary has as a resource to tackle Original Medicare’s Coinsurance, Copays, and Annual Deductibles is through the use of a Medicare Advantage plan, also known as Medicare Part C.

Medicare Advantage Plans are CMS-approved insurance plans offered through private health insurance companies. They combine Original Medicare Part A, Part B, and generally Part D into one plan. Enrolling in a Medicare Advantage plan requires a person to be entitled to Medicare Part A, enrolled in Medicare Part B, and reside in the plan's service area. Medicare Advantage plans, at a minimum, include all benefits, services, and coverages outlined in Original Medicare. They generally have additional benefits and services Medicare does not cover, such as:

  • Dental
  • Vision
  • Hearing

Medicare Advantage plans provide an affordable option to reduce the exposure to Medicare’s copays, annual deductibles, and 20% coinsurance. By selecting a Medicare Advantage plan, the insurance company becomes your primary insurance, and by doing so, it has very distinct advantages and disadvantages, such as:

Advantages:

  • They Have A Low or No Monthly Plan Premium.
  • Part D Is Generally Included In The Plan.
  • They Provide Predictable Out-of-Pocket Costs.
  • They Usually Include Extra Benefits Not Provided By Original Medicare.

Disadvantages:

  • As A Rule, Working Within A Network Is Mandatory.
  • Typically, Working With A Primary Care Physician Is Mandatory.
  • Sometimes They Require A Referral To See A Specialist.

CMS = Centers for Medicare & Medicaid Services

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