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Medicare Part C offers health and wellness advantages in addition to what you receive from Medicare Parts A and B. You’re eligible for all the plans once you turn 65. Get the facts about Medicare Part C to help you decide if this optional plan is right for you.

Medicare Part C coverage

Medicare Part C, a Medicare Advantage (MA) Plan, is optional coverage that provides all of your Part A (Hospital Insurance) and Part B (Medical Insurance) coverage. Traditional Part C benefits include plans for services like home health care, vision, hearing and dental. The plan has evolved to include extra wellness benefits such as transportation to doctor visits, wheelchair ramp construction, nutrition counseling and more at no additional out-of-pocket cost. These offerings are intended to keep you healthier and safer, and ultimately reduce health care costs.

To qualify for Part C, you must first be enrolled in Parts A and B. Often Part C is paired with Medicare Part D, which is optional prescription drug coverage. Check the Medicare website for plan premium costs.

Medicare types

There are four parts of Medicare: Part A, Part B, Part C and Part D.

Medicare Type

Medicare Part A

Medicare Part B

Medicare Part C

Medicare Part D

Purpose

Provides inpatient care at hospitals, skilled nursing facilities, home health care, hospice care and more.

Provides outpatient/medical coverage, doctor care and other health care services.

Provides hospital and doctor coverage plus added benefits like nutrition counseling, medical transportation and more.

Provides prescription drug coverage.

How does Medicare Part C work?

When it comes to managing your health, Part C lets you choose from a network of doctors and hospitals to deliver your health care needs, in- or out-of-plan. Once enrolled in Part C, you can choose a private health insurer that offers one of the following plans, just as you would if you only had Part B:

  • HMO (Health Maintenance Organization)
  • PPO (Preferred Provider Organization)
  • PFFS (Private Fee for Service)
  • SNP (Special Needs Plan)

Your insurer must follow the rules set by Medicare. However, each of the above plans may have different rules outlining how you receive services, such as whether you need a referral to see a specialist and/or if you’re required to use in-plan doctors’ offices for non-emergency care. These rules can change each year; therefore, it’s a good idea to check with your plan provider if you have questions regarding coverage.

How much does a Part C plan cost?

The North Carolina Department of Insurance Seniors’ Health Insurance Information Program (SHIIP) has a Medicare Supplement Premium Comparison Database that allows you to find the estimated premium rates for your Medicare supplement plans.

Get to know more about Medicare plan basics before you enroll. The Medicare Plan Finder lets you search by zip code for available plan options near you. For additional Medicare guidance, contact your local Social Security office or Seniors’ Health Insurance Information Program (SHIIP) with the N.C. Department of Insurance.

The advice provided is for informational purposes only. Contact a financial advisor for additional guidance. 

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