While every American who reaches age 65 becomes automatically enrolled in the Original Medicare plan that includes Part A, inpatient, and Part B, outpatient care, this traditional health plan doesn’t provide Part C coverage for dental, vision, hearing, and prescription drugs. Advantage Medicare plans, that include Medicare Part C benefits and often more, may be the better choice for you if you need those health products and services and meet the eligibility criteria.
Medicare Part C: Is a Medicare Advantage Plan Right for You?
What’s Your Eligibility?
Unlike Original Medicare with the Part A and B plans that are government-operated and public, Medicare Advantage Part C plans are private health insurance options that medical insurance companies run. Enrollees with pre-existing medical conditions are eligible for Part C Medicare plans. All enrollees for Part C Advantage plans must already be enrolled in Original Medicare.
With Original Medicare, you most likely won’t require a doctor’s referral to specialists, but you probably will with Advantage Medicare. You also won’t be eligible for an Advantage plan unless you meet the requirements for how far your home is from the local health care providers your plan includes. For that reason, it’s essential to know which local doctors and other health care providers you will have covered access to if you choose Advantage Part C Medicare.
Are You a Frequent Traveler?
With both Medicare options, you’ll be covered when traveling within the United States. if you require hospital care or specific tests or disease treatment under Part A and Part B, but if you’re on an Advantage Plan, the Part C coverage won’t apply when you’re out of your local area. You won’t be covered for your Plan C health care products and services until you’re back home. So, if you’re not likely to travel outside your area, an Advantage plan might be right for you.
Will You Save Money?
Since Original Medicare doesn’t include dental, hearing, vision, and prescription drug coverage, a Medicare Advantage Plan can work well for many enrollees and save them money in out-of-pocket costs. Part, A care in both Original and Advantage Medicare covers only hospital and inpatient care. At the same time, Part B provides coverage for outpatient services and yearly check-ups, screenings, vaccines, mental health counseling, and disease treatment.
But most health insurance enrollees do need coverage for prescription drugs and one or more other areas such as hearing or dental. Plus, with a Part C Medicare plan, your out-of-pocket medical expenses may be lower than with the traditional version since once you reach your yearly spending cap, you don’t pay for the rest of the year. Just be sure you know what exactly your Part C coverage is within your individual Advantage Medicare plan.
Are Your Needs Met With a Particular Part C Plan?
All Part C Medicare plans have to cover urgent and emergency care by federal law. But other than that, Advantage Medicare plans differ significantly between insurance companies. Most Medicare Advantage Part C plans also cover prescription drugs, dental, hearing, and vision, but some offer additional benefits like transportation to and from medical appointments, adult day care services, fitness program coverage, or specific disability or illness coverage.
Need help deciding if Part C Medicare coverage is right for you? Brooker Medicare has over 15 years of experience helping Americans understand all Medicare options because what’s right for one person may not be the best fit for someone else. Contact your licensed Medicare specialist, Brooker Medicare, today to find the best Medicare plan for you.