Medicare Part C

Part C is a commonly used term for Medicare Advantage. 

Medicare Advantage plans take care of your Part A and B coverage as well as bringing added benefits you cannot get through Original Medicare.

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How do Medicare Part C plans work?

You have to be enrolled in Medicare Part A and B to be eligible to purchase a Medicare Advantage Plan.

When you receive healthcare services, you will present your Advantage Plan card as payment. 

Part C plans normally come in two different types: HMO or PPO. 

Most HMO plans require you to receive your healthcare in its network and choose a primary care physician. Out-of-network visits are only allowable in cases of emergency. If you want to visit a specialist, you’ll be required to receive a referral from your primary care physician.

PPO plans allow for out-of-network coverage but it will be more expensive for you. PPO plans do not require you to choose a primary care physician or require a referral for you to see a specialist.

Additional benefits with Part C

Part C takes over for your Part A and B coverage, but it also comes with additional benefits like: 

  • Adult day-care services
  • Dental
  • Fitness memberships
  • Hearing
  • Nutrition programs
  • Prescription drugs
  • Over-the-counter drugs
  • Services and supports for those with chronic conditions
  • Transportation to doctor visits
  • Vision
  • Wellness programs

However, benefits your plan offers will vary based on where you live. We can look into this for you. Just give us a call!


Out-of-pocket maximum for Medicare Advantage plans

An overlooked benefit of Part C plans is its out-of-pocket maximum limit. Original Medicare does not put a cap on how much you pay for your healthcare.

We can take a look at what plans available in your area offer for your out-of-pocket max. If you hit this limit, your Medicare Advantage plan pays 100% of any other eligible expenses you receive.

How to get a Part C plan

When you become eligible for Medicare, give us a call to help you find a plan in your area!