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Question: What is Medicare Part C?

October 8, 2010

Medicare Part C, also known as Medicare Advantage, is a way to expand your health insurance coverage beyond Medicare Parts A and B. Learn more about Medicare Part C and whether this health insurance option may be right for you.

Answer: Medicare Part C plans are available to seniors and certain disabled individuals who are eligible for Medicare. The plans are also called Medicare Advantage policies, and may provide different medical coverage than traditional Medicare.

Medicare Part C: Services

These health insurance policies combine Medicare Part A, which covers hospitalizations and related care, and Medicare Part B, which covers outpatient services and preventive care. Depending on the type of Medicare Advantage plan you select, Medicare Part C may also offer other benefits, including:

  • Vision
  • Dental
  • Hearing
  • Health and wellness
  • Prescription drugs

Medicare Advantage plans give participants the same rights as Medicare Parts A and B, including the right to appeal claim denials or service exclusions.

Medicare Part C: Provider options

With Medicare Advantage, both inpatient and outpatient care are covered on the same policy. In addition, Medicare Advantage plans are offered through private insurance companies that have been government approved. When reviewing your Medicare Part C options, you will find the following types of Medicare Advantage policies:

  • Health Maintenance Organizations (HMO)
  • Preferred Provider Organizations (PPO)
  • Private Fee-for-Service (PFFS)
  • Medical Savings Accounts (MSA)
  • Special Needs Plans (SNP)
  • Point of Service (POS)
  • Provider Sponsored Organizations (PSO)

While all Medicare Advantage policies must adhere to government regulations, insurance companies are allowed flexibility to set premium amounts, network providers and referrals to specialists. For example, Medicare Advantage health insurance plans may have different out-of-pocket requirements. That's why it is important to review the medical coverage limits, as well as plan premiums when considering these health insurance plans.

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