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Medicare Part C Offers New Healthcare Options

When Medicare was first created in 1965 it was comprised of only Part A and Part B; Medicare Part C was non-existent. Luckily, Medicare continued to change as needs expanded, and with the Balanced Budget Act of 1997, Medicare beneficiaries were given the choice to receive their Medicare benefits from private health insurance plans, instead of through the original Medicare Part A and Medicare Part B Plans. This new choice was originally named very creatively as “Medicare+Choice,” but is now more often referred to as Medicare “Part C”.

Medicare Plan C (Medicare Advantage plan) is a type of health plan available to those on Medicare. This type of health plan is approved by Medicare but run by private companies. The number one reason most people opt in for this plan is for the lower co-pays. However, in this plan there is a specific set of providers that these health insurance patients can use. While the option to go outside the network is doable, going around the network may require special authorization or added costs. Also remember that with Medicare plan C, you’ll need to have a primary care physician who will oversee all of your care and who will be your primary point of references for referrals to specialists when necessary.

Medicare Part C plans are required to offer similar or even better coverage than one would receive under the original Medicare program, each benefit is not always covered in the same manner. If you think this is unfair, read on…

If your coverage under Medicare plan C pays less than Medicare for a benefit such as a hospital stay, the savings are then provided to you in another area such as a lower copayment for a doctor visit. Another benefit is that these plans offer services not covered under Medicare Part A or Medicare Part B. Some of these added insurance benefits may include such expenses as dental coverage or vision coverage.

If your interest has peaked, the next step is to consider your Medicare Plan C costs.
Medicare Part C Plan costs are dependent upon:

  • Whether your plan C charges an additional monthly premium added on to your Part B premium.
  • Whether your plan pays any of the monthly Part B premiums.
  • Additional Plan C deductibles.
  • The cost to you for each visit or service under this health plan.
  • The frequency and type of health care services you need.
  • Whether you use in network plan providers.
  • Whether your health care plan has a limit on your out-of-pocket costs for all health services you need.
  • What the premium of this plan costs.
  • Does the plan cover the extra benefits or services you need (such as coverage for vision, hearing, dental, or health and wellness programs)?
  • Are the health care providers you already see covered in this plan?

In essence using Medicare Plan C will help you to save the most money on your health insurance costs, but your choice of health care providers is definitely narrower than it would be with other options. You are usually covered only when you see doctors and specialists, or go to hospitals that are part of the Medicare plan’s network of providers, within the plan’s service area. For many this health allows those who are eligible a voice in their care, as well as the chance for savings.