5 Things to Know About Medicare Part C Coverage - Insurance for Seniors, LLC.
What is Medicare Part C and what does it cover? Find out by reading these five important things about Medicare Part C coverage.
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5 Things to Know About Medicare Part C Coverage

5 Things to Know About Medicare Part C Coverage

According to the US Center for Medicare & Medicaid Services (CMS), over 60 million Americans are a part of the Medicare insurance system today.

There is also another layer of additional services on top of the basic service level that the government provides its members. This added layer is called Medicare Part C coverage.

You can learn more here on five important things you should know about Medicare Part C. Master these basics now so that you can make an informed decision on this well-deserved privilege.

1. What is Medicare?

Medicare is the federal government’s health insurance program that allows patients to pay for portions of their health care expenses. The Medicare system pays for the rest.

The Medicare insurance system was created in 1965. This health care coverage was designed to help America’s senior citizens who couldn’t get their own health insurance regardless of their medical history or annual income.

2. What is Original Medicare Part A and B?

The Medicare insurance system offers different levels of health care coverage for qualified patients. Many people misunderstand the differences between these plans.

The Medicare insurance program offers two original plans that any member can access today. Medicare Parts A and B were the first forms of the coverage that were established in 1965. Every member in the Medicare system has access to original Medicare Part A and B services.

Original Medicare Part A pays for fees like in-hospital expenses or home-health care fees. Original Medicare Part B can pay for costs like diagnostic test expenses, doctor exam co-pay fees, and medical equipment costs.

3. What is a Medicare Advantage Plan?

If you want health insurance coverage beyond what the Original Medicare Parts A and B provide, you can buy a Medicare Advantage plan policy that will provide you with additional health services.

A Medicare Advantage Plan can help cover those out-of-pocket costs that neither Original Medicare Parts A or B can pay for.

You can buy a Medicare Advantage plan from private insurance agencies that contract with the government to provide additional coverage above the Original Medicare Part A and B coverage.

State and federal laws regulate the design for advantage plans to make sure they all have the same Original Medicare services are included in in each plan.

Right now, there are ten different advantage insurance plans that provide additional services above what you can find in Original Medicare Parts A and B.

You can see these services highlighted on this Medicare comparison chart that outlines each of the advantage plans available today.

4. What Is Medicare Part C Coverage?

One advantage plan example is Medicare Part C. Part C covers additional medical expenses like dental and hearing exams. It also covers additional medical expenses like wellness program costs for a higher fee.

Enrollees can apply for Plan C services when they sign up with health care plans that participate within a defined plan service area. These types of plans include:

  • Private Fee-for-Service (PFFS) Plans;
  • Preferred Provider Organization Plans (PPS);
  • Special Needs Plans (SNPs); and
  • Health Maintenance Organization Plans (HMO’s).

A PFFS plan contracts with CMS to provide patient services. A PPFS plan determines how much they will pay a doctor, hospital, , or other health care professional. They also decide what amount a patient l pays when they receive services.

Private insurance companies offer PPS plans. A PPS plan has a network of physicians, hospitals, and other health care providers.

PPS members also pay a smaller fee when they use these physicians and hospitals that belong in the plan’s network.

An SNPS plan limits membership to enrollees who have a specific disease or other special need. An SNPS plan alters their offered benefits and provider choices, to meet these types of needs.

With an HMO Plan, the member chooses one primary care physician. All of their medical services will go through that one physician.

Patients need a referral before they can see another health care professional.

5. Recent Changes to Medicare Part C Coverage

In 2020, Medicare Part C was no longer available to new Medicare program enrollees. People who were apart of the Medicare system before 2020 are still eligible to sign up for Medicare Part C coverage. coverage.

2021 brought on even more dramatic changes for these Medicare advantage plans. Starting in January, Medicare advantage plan premiums declined by more than 30 percent. These plan premiums are at the lowest levels they’ve been since 2007.

Enrollment in the Medicare system, however, continues to rise. CMS estimates that more than 20 million new enrollees will enter the system before this year is over.

There are currently more than 4,000 Medicare Advantage plans on the market to choose from. All of these plans are competing with each other to offer their versions of the optimal health care coverage that’s available today.

Medicare advantage plans also now accept enrollees at any age who qualify for Medicare due to end-stage renal disease (ESRD) or kidney failure.

Ready to Sign Up For Medicare Part C Coverage?

Are you ready to capitalize on the benefits that Medicare Part C coverage to boost your current health plan? If so, you can start today.

Review the Medicare Supplement plans comparison table mentioned above just to confirm that Medicare Part C is the best choice for you.

Then you can meet with your insurance agent and ask them to augment either your current HMO or PPS plan so that you can enjoy this added level of service.

You can also learn more about the different types of Medicare plans out there today at our website. Do your homework today. Then you can enjoy that benefit you worked an entire career to earn.