Part C

Medicare Advantage Plans

Medicare Part C is more popularly referred to as “Medicare Advantage” Plans or MA Plans. A common misconception is if you join a Medicare Advantage Plan, you no longer have Medicare. However, you still have Medicare when joining an MA Plan and are still responsible for paying your Medicare Part B premium.

Medicare Part C

What is Medicare Part C?

Medicare Part C or Medicare Advantage, are plans offered by private insurance companies approved and contracted with Medicare. In addition to providing Medicare Part A and Part B benefits, MA Plans usually include additional coverage, such as prescription drugs, vision, and/or dental, which is why they are often confused with Medicare Supplement (“Medigap”) Plans. If you join a Medicare Advantage Plan, you still have Medicare. You’ll still get your Medicare Part A and Medicare Part B coverage, however it will be provided from the Medicare Advantage Plan and not Original Medicare. (Complicated, right?) Below are some important things to remember when considering Medicare Part C / Medicare Advantage Plans:

  • MA Plans are offered by private insurance companies approved by the Federal Government.
  • Medicare Advantage Plans must, at a minimum, cover services of what Medicare Part A & Part B cover.
  • MA Plans usually offer additional benefits not covered by Original Medicare (Parts A & B), such as dental and vision.
  • You must be enrolled in Parts A & B to be eligible for a Medicare Advantage / Part C plan.
  • You must continue to pay your Part B Premium.
  • Medicare Advantage / Part C plans can be an HMOs, PPOs, or PFFS Plan depending on plan availability in your area.
  • You cannot have both Medicare Advantage and Medicare Supplement (Medigap) coverage at the same time. Compare differences between Medicare Advantage Plans & Medigap Plans.

Different Types of Part C / Medicare Advantage Plans

Health Maintenance Organization (HMO) Plans
Preferred Provider Organization (PPO) Plans
Private Fee-for-Service (PFFS) Plans
Special Needs Plans (SNPs)

Who can join a Medicare Advantage Plan?

You can generally join a Medicare Advantage Plan if you meet the following requirements:

  • You live in the service area of the plan you want to join. If you live in another state for part of the year, check to see if the plan will cover you there.
  • You have Medicare Part A and Part B.
  • You do not have End-Stage Renal Disease (ESRD).

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