Medicare Part C

Resources > Medicare Part C

Medicare Advantage

A Medicare Part C plan is a private insurance policy that replaces Medicare Part A and Part B. This means that if you enroll in a private Medicare Part C plan, you no longer receive coverage through Medicare Part A or Medicare Part B.

Medicare Part C plans are regulated by the federal government, which requires every plan to provide at least the same coverage as the government-run Medicare Parts A and B. If you enroll in a Medicare Part C plan, you don’t need to buy a Medigap policy.

Keep in mind that each Medicare Part C plan is slightly different, depending on what that plan’s private insurance company chooses to offer beyond basic Medicare.

Why look at Medicare Part C plans? The main benefit is cost. However, there can be some drawbacks to the Medicare Part C plan. Two areas of concern are choosing a doctor covered by your plan and needing to see a specialist. If you want to consult a doctor who’s not in the plan’s network, you’d have to pay some or all of the cost yourself.

If you’re considering a Medicare Part C plan, one of your first steps should be to see if your regular doctors are in the plan’s network. If not, and you want to stay with your doctors, that plan isn’t a good one for you.

In cases where you may need to see a specialist for concerns not covered by your regular doctor, under Plan C, even if a specialist or specialized treatment is deemed necessary by your physician, Medicare Part C will not cover the charges if they view the specialized treatment as unnecessary. Therefore, any charges that occur will be the individual’s responsibility, not Medicare’s.

As you can see, there are benefits and drawbacks to Medicare Part C. This is why it’s important to choose a Medicare Agent who is knowledgeable about all aspects of Medicare to help you choose the plan that’s right for you.