What is Medicare Part C?

Also known as Medicare Part C, Medicare Advantage plans provide everything in Original Medicare, plus additional coverage and benefits. Find out what they cover and if a Part C plan is right for you.

What’s the difference between Original Medicare and Medicare Advantage?

Original Medicare

  • Includes Part A and Part B.
  • Part A covers inpatient medical needs like hospitalization and stays at a skilled nursing facility.
  • Part B covers outpatient care such as doctor visits, medical tests, and preventative care.

Medicare Advantage (Part C)

  • Offered by private insurance companies.
  • All-in-one plans cover everything included in Original Medicare, plus additional benefits such as dental, vision, and prescription drug coverage (Medicare Part D).

What does Medicare Part C cover?

 

  Prescription drug (Part D) coverage

 

  Routine dental care (X-rays, exams, and dentures)

 

  Vision care (glasses and contacts)

 

  Hearing care (testing and hearing aids)

 

  Over-the-counter spending allowance

 

  Wellness programs

 

  Fitness center memberships

What is the cost of Medicare Part C (Medicare Advantage)?

 

One of the benefits of Medicare Part C is your out-of-pocket costs are capped for covered services. Once you’ve reached your cap, you pay nothing for the rest of the year.

 

Many Medicare Advantage plans have $0 monthly premiums and $0 medical deductibles (you will still need to pay your Parts A and B monthly premiums). There are co-pays for doctor visits, hospital stays and prescription drugs. Costs vary based on the plan you choose and where you live.

 

You can usually find a Medicare Advantage plan that fits your budget. Wellpoint has many plan options. If you’re living on a low or limited income, you can take advantage of money-saving programs.

Do I need a Medicare Advantage plan?

 

Many people who have Original Medicare decide they need additional coverage. Almost half of all Medicare enrollees – over 30 million people - sign up for plans like Medicare Advantage that provide more coverage. Why?

 

  Convenience of an “all-in-one” plan with more benefits than Original Medicare

 

  $0 and low monthly premiums for most plans

 

  Greater control over out-of-pocket costs

 

Recent studies have also shown improved health outcomes and overall lower costs with a Medicare Advantage plan over other plan types.

How do I enroll in a Medicare Advantage plan?

 

You can enroll in, add, change, or drop your Medicare Advantage plan during these periods:

Enroll

Initial Enrollment Period, which starts three months before your 65th birthday month and ends three months after

Add or change

Annual Enrollment Period, October 15 to December 7

Change (one-time only)

Medicare Advantage Open Enrollment Period, January 1 to March 31

Add, drop, or change

Special Enrollment Period, based on certain life changes (such as moving to a new area)

Wellpoint and Carelon Health plans are Medicare Advantage plans with Medicare contracts. Wellpoint and Carelon Health plans are SNP plans with a Medicare contract and a contract with the state Medicaid program. Enrollment in Wellpoint or Carelon Health depends on contract renewal.