Medicare Advantage Plan (Medicare Part C) – Combining your Coverage
Medicare Advantage plans (Medicare Part C) are administered by private insurance companies such as Clear Spring Health and offer extra benefits not available with Original Medicare.
Medicare Advantage plans consist of a network of health care providers that together provide you with additional benefits. Networks can be more efficient which results in lower overall health care costs. Some Medicare Advantage plans require you to use their network of providers. Others, such as Clear Spring Health, allow you to see the physician of your choice.
Before signing up for a Medicare Advantage Plan, you need to sign up for Medicare Part A and Part B and enroll in the Medicare Advantage Plan directly with the private insurer that offers the benefits that best suit your needs.
Did You Know?
- Must be enrolled in both Parts A and B and live in plan service area
- Cannot be denied coverage based on current financial or health status including pre-existing conditions
- May be required to use provider and pharmacy networks
- Coverage and costs vary per plan and may change each year
- There may be an annual limit on out of pocket costs for covered service
- You may be charged a monthly plan premium
- Must continue to pay Part B premium to Medicare
- Most plans include prescription drug costs
All Medicare Advantage Plans Cover:
- All the benefits of Part A (except hospice care, which is still covered by Part A)
- All the benefits of Part B
In addition, most Medicare Advantage Plans Cover these extras:
- Prescription Drugs
- Emergency care covered at any facility and at a generally lower cost of services in-network
- Guaranteed maximum yearly limit on out of pocket costs for covered medical services. This is sometimes called, out-of-pocket maximum. Once the limit is reached, there is no charge for covered services for the rest of the plan year.
Medicare Advantage Plans may offer even more benefits such as:
- $0 monthly plan premium
- Dental exams, cleanings and X-rays
- Eye exams, eyeglasses and corrective lenses
- Hearing tests and hearing aids
- Wellness programs and fitness memberships such as Silver Sneakers
$What does Medicare Part C cost?
When you choose a Medicare Advantage plan, you will continue to pay a monthly Medicare Part B premium. While premium pricing varies, depending on the Medicare Advantage company you choose, many Advantage plans offer $0 premium plans and they also set the amounts for your deductible, coinsurance, and copays. You get an additional benefit with Medicare Advantage that is not available with Original Medicare: a limit on the annual amount you pay for your covered medical care (out-of-pocket maximum).