Medicare Part C is a part of a health insurance plan provided by private insurance companies in partnership with Medicare. Medicare Part C, or Medicare Advantage, offers the same benefits as Medicare Part A and B (Original Medicare), as well as other benefits.
So, do you need a Medicare Advantage Plan? Not necessarily, but the choice is truly based on what type of coverage you’re looking for and on what budget because Medicare Part C and Original Medicare have different costs and percentages.
Medicare Part C Coverage for Inpatient and Outpatient Services
Medicare Part C covers both inpatient and outpatient care, offering the same coverage that is under Original Medicare.
Part C takes care of inpatient hospital care, home health care, and inpatient expert nursing care. Part C also provides the same benefits as Medicare part B and additional healthcare plans such as:
- Laboratory tests and X-rays
- Ambulance services
- Inpatient and outpatient services for mental health
- Heavy-duty medical equipment like wheelchairs and walkers
- Preventive screenings and vaccinations such as flu shots
- Physical therapy
- Doctor visits (specialists and primary health care providers)
- Speech and language therapy
- Occupational therapy
For outpatient services, the cost-sharing amounts of Part C and Part B differ.
Additional benefits of Medicare Part C
One additional benefit that Part C covers are prescription drugs that are not provided by Original Medicare. However, there is a list of prescription drugs covered by Part C in the formulary. Depending on the plan you choose, the formularies will differ.
Here are some other additional benefits of Part C:
- Fitness benefits such as gym classes
- Regular vision essentials such as eyeglasses and contacts
- Routine dental services like x-rays, teeth cleaning, and dentures
- Regular hearing services such as hearing aids
Keep in mind that Part C plans do not cover all these benefits in a similar way. For example:
There are Part C plans that only provide dental health care benefits. This means that it will only cover dental care in the case of a disease or damage from an accident. If you have an extensive plan that includes dental benefits or other benefits, you may have to pay a higher premium.
Importance of Medicare Advantage
With Medicare Advantage, you don’t have to worry about purchasing separate plans for inpatient and outpatient care. Medicare Part C serves as a cheaper, alternative option to Original Medicare for those who are looking for the same coverage, but with additional benefits.
Part C also offers a broader range of health care plans to choose from.
If you feel you are not receiving the right amount of healthcare coverage, you can file an appeal with your Medicare Advantage Plan, or any other Medicare plan you might have. You can appeal for specific healthcare services, medical supplies, prescription drugs, or any other service that should be covered by your health plan, but is not. You can also appeal for a reduction in your fees. If your appeals aren’t considered, or you are not satisfied with your plan, you can change your Medicare Advantage Plan during the annual Open Enrollment Period that lasts from October 15 and ends December 7.
You can also change your Medicare Advantage Plan during the Medicare Advantage Open Enrollment Period that lasts from January 1 to March 31.
At Hitcho Insurance, we work with you to find the best Medicare policy that suits your needs, your goals, and your finances. If you’re wondering which Medicare Advantage Plan is right for you, then give us a call today at (610) 694-9435 and receive a free consultation.
