Medicare Part C, also known as Medicare Advantage, covers both Medicare Part A and B benefits and must cover all medically necessary services. It’s also common that Medicare Advantage includes Part D coverage as well.
Making the decision to enroll in Medicare Advantage is a big one and should be a well-informed one. These three facts are vital to know in order to make your decision:
You’ll have more coverage options.
One of the greatest allures of Medicare Advantage plans is the variety of choices you have available. Medicare Advantage plans are offered by private insurance companies which means they contain all the components of Medicare in one package. Original Medicare beneficiaries will have to enroll in each part separately. Also, Medicare Advantage plans typically cover your basic vision, hearing, and dental exams, which are not covered under Original Medicare.
There are annual out-of-pocket limits, but they could be higher.
Under original Medicare, there are no limits on how much of your own money you can pay for medical care. Typically with original Medicare, it covers 80 percent of your medical expenses, with the remainder being your responsibility. If you have to undergo treatment with any new cancer drug, you could be looking at an annual out-of-pocket cost of more than $20,000. That’s where a Medicare Advantage plan can come in handy.
Although Medicare Advantage plans limit how much you’ll owe in out-of-pocket fees, there are no guarantees that your out-of-pocket payments leading up to that $7,550 won’t be higher under a Medicare Advantage plan. It’s also important to know that prescription drug costs don’t count toward your annual out-of-pocket limit.
You still get Medicare coverage.
When you don’t enroll in Original Medicare, it doesn’t necessarily mean that you’re giving up the services or rights that come with Original Medicare. With the exception of hospice care, Medicare Advantage plans are required to offer the same services as Original Medicare Part A and Part B. Even if you’re not enrolled in Original Medicare, it will still step in and cover hospice care. You’re also protected from paying excessive costs for some services under Part C.