What Is Medicare Part C Coverage?

Medicare is a federal program that provides medical benefits for individuals in the United States who are over the age of 65 or have a qualifying disability. This medical plan is broken down into several different types of coverage. Medicare Part C is one component of this plan that offers optional coverage to eligible applicants.

What Is Medicare Part C?

• When you become eligible for Medicare, you have the choice to be enrolled in Medicare Parts A and B or to enroll in Part C. Parts A and B are provided directly by the federal government. Part A gives you hospital coverage while Part B gives you doctor coverage. Part C is optional coverage provided by a private insurer. This type of plan is also called a Medicare Advantage plan, and it combines the benefits of Parts A and B.

Paying for Coverage

• Medicare Part A coverage is provided at no charge to most individuals by the federal government. If you opt for a Part C plan, the government will pay part of the premiums that you would normally have to pay if you had elected Part A coverage. The rest of the money for your insurance premiums must be paid out of your own pocket. The amount that these companies can charge is limited by Medicare rules.

Types of Plans

• With Part C coverage, there are a few different types of plans that you can access. One type of plan is a preferred provider organization (PPO). With this plan, you can see any doctor or facility, but you will pay more for providers that do not contract with the PPO. Another kind of plan is a health maintenance organization (HMO). This plan only allows you to see doctors inside the network. There are also private fee for service plans that require you to pay a specific fee for each type of service you need.

Other Benefits

• Many people who are eligible for Medicare choose a Medicare Advantage plan because of the various benefits that it provides on top of what you can get from traditional Medicare. For example, many of these plans offer prescription drug benefits. You can also get plans that include vision and dental insurance, along with the standard medical benefits. Some policies also provide assistance with long-term care or skilled nursing facilities.