Medicare Part C Coverage: An Expert Guide (2024)
Also called Medicare Advantage, Medicare Part C coverage offers supplemental plans for things Parts A and B don’t include. Unlike Parts A and B, Medicare Part C plans are sold through private companies. Some people only pay their monthly Part B rates, while other plans can cost over $60 per month.
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Justin Wright
Licensed Insurance Agent
Justin Wright has been a licensed insurance broker for over 9 years. After graduating from Southeastern Seminary with a Masters in Philosophy, Justin started his career as a professor, teaching Philosophy and Ethics. Later, Justin obtained both his Property & Casualty license and his Life and Health license and began working for State Farm and Allstate. In 2020, Justin began working as an i...
Licensed Insurance Agent
UPDATED: Nov 27, 2023
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Our insurance industry partnerships don’t influence our content. Our opinions are our own. To compare quotes from many different insurance companies please enter your ZIP code on this page to use the free quote tool. The more quotes you compare, the more chances to save.
Editorial Guidelines: We are a free online resource for anyone interested in learning more about insurance. Our goal is to be an objective, third-party resource for everything insurance related. We update our site regularly, and all content is reviewed by insurance experts.
UPDATED: Nov 27, 2023
It’s all about you. We want to help you make the right coverage choices.
Advertiser Disclosure: We strive to help you make confident insurance decisions. Comparison shopping should be easy. We are not affiliated with any one insurance provider and cannot guarantee quotes from any single provider.
Our insurance industry partnerships don’t influence our content. Our opinions are our own. To compare quotes from many different insurance companies please enter your ZIP code on this page to use the free quote tool. The more quotes you compare, the more chances to save.
On This Page
- Medicare Part C is also known as Medicare Advantage and private health insurance companies provide it to cover Medicare Part A and Part B services under one plan
- Medicare Part C eligibility requires that you be enrolled in Parts A and B
- Many people who are enrolled in Medicare Part C do not have to pay a premium other than the Medicare Part B premium
Medicare Part C is one of the four main parts of Medicare (Medicare Part A, Part B, Part C, and Part D) and is sold by private health insurance companies. Often, Medicare Part C covers additional benefits that original Medicare coverage does not. Many Americans see Medicare Part C costs nothing more than their Plan B premium, while others pay upwards of $60 per month.
Also called Medicare Advantage, Medicare Part C plans combine Parts A and B into one simple policy. Many Medicare Advantage plans offer the possibility of additional coverage, like Medicare Part C dental coverage and vision insurance.
Read on to learn more about Medicare Part C coverage, including what it covers and how much it might cost. Then, compare rates and plans with multiple companies to find the right coverage for you.
Table of Contents
Medicare Part C Explained
What is Medicare Part C and D? Medicare Part C is also known as Medicare Advantage. These plans are purchased from private health insurance companies approved by Medicare.
- Medicare Advantage
- Best Wyoming Medicare Advantage Companies & Plans (2024)
- Best Texas Medicare Advantage Companies & Plans (2024)
- Best South Dakota Medicare Advantage Companies & Plans (2024)
- Best Pennsylvania Medicare Advantage Companies & Plans (2024)
- Best Oregon Medicare Advantage Companies & Plans (2024)
- Best Oklahoma Medicare Advantage Companies & Plans (2024)
- Best North Dakota Medicare Advantage Companies & Plans (2024)
- Best New Hampshire Medicare Advantage Companies & Plans (2024)
- Best Nevada Medicare Advantage Companies & Plans (2024)
- Best Montana Medicare Advantage Companies & Plans (2024)
- Best Missouri Medicare Advantage Companies & Plans (2024)
- Best Michigan Medicare Advantage Companies & Plans (2024)
- Best Massachusetts Medicare Advantage Companies & Plans (2024)
- Best Maine Medicare Advantage Companies & Plans (2024)
- Best Louisiana Medicare Advantage Companies & Plans (2024)
- Best Kansas Medicare Advantage Companies & Plans (2024)
- Best Illinois Medicare Advantage Companies & Plans (2024)
- Best Idaho Medicare Advantage Companies & Plans (2024)
- Best Georgia Medicare Advantage Companies & Plans (2024)
- Best Florida Medicare Advantage Companies & Plans (2024)
- Best Colorado Medicare Advantage Companies & Plans (2024)
Medicare Part D is prescription drug coverage, which is generally included in Medicare Part C plans. Medicare Part C also includes Medicare Part A (inpatient care) and Medicare Part B (outpatient care). In addition, Medicare Advantage plans may also provide extra coverage, such as vision or dental.
The Medicare program sets rules and guidelines that private health insurance companies must follow when they offer Medicare Advantage plans.
However, the companies have the freedom to set your out-of-pocket costs and rules for how to get services, such as needing a referral.
To meet the Medicare Part C eligibility requirements, you must live in the service area for a specific plan, have Medicare Part A and Part B, and be a lawful resident or citizen of the United States.
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Medicare Part C Coverage
Medicare Part C coverage must have everything that Medicare Part A and Part B cover, including:
- Inpatient hospital care
- Skilled nursing facility (SNF) care
- Emergency care
- Doctor’s visits
- Preventative care
- Durable medical equipment (DME)
About 90% of Medicare Advantage plans also include Medicare Part D, which covers most prescription drugs. In addition, some plans will offer higher coverage than original Medicare and provide additional benefits, such as vision, hearing, dental, or health and wellness programs.
Recently, private health insurance companies have been approved to offer more benefits, such as adult daycare, in-home support services, and safety modifications like wheelchair ramps.
While Part C can cover extra services, it might not cover everything. If you’re looking for even more Medicare supplemental coverage, a Medigap insurance plan might be right for you.
Read more: What does health insurance cover?
Medicare Part C Coverage Costs
About 65% of Medicare Advantage policyholders pay no premium for their plan other than the Medicare Part B premium (starting at $164.90 per month in 2023). About 15% of policyholders pay at least $50 per month in addition to the Medicare Part B premium.
Of the policyholders who have to pay a premium on top of the Medicare Part B premium, the average cost is $60 per month. (If you include the policyholders who do not have to pay a premium, this drops the average cost down to $21 per month.)
Some companies will also help pay for Medicare Part B, so you may even pay less than the standard premium. The health insurance company is also responsible for setting the deductible cost, coinsurance, and copayments.
Medicare Part C Networks
Medicare Advantage plans are organized into networks containing various types of facilities and health care providers to ensure that you have access to the care you need.
Around 62% of Medicare Advantage enrollees belong to health maintenance organizations (HMOs). An HMO will only cover costs for in-network providers unless you need medically necessary emergency care from an out-of-network provider.
Around 36% of Medicare Advantage enrollees belong to preferred provider organizations (PPOs). PPOs will cover costs for in-network and out-of-network providers, but your out-of-pocket costs will be more expensive for out-of-network care.
A small percentage of Medicare Advantage plans are private fee-for-service (PFFS) plans, Medicare medical savings account (MSA) plans, or special needs plans (SNPs).
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How to Get Medicare Part C Coverage
You can begin searching for Medicare Part C plans by using Medicare’s plan finder. The search should make it easy to understand the details of each plan and compare plans.
You should be able to find plenty of information on plans online. You can visit each company’s website to see if it’s possible to enroll in the plan online. If it’s not possible, you can fill out and send in an enrollment form for the plan of your choice.
If you need further help, you can also call Medicare at (800) 633-4227 (TTY: (877) 486-2048).
When you’re ready to enroll in a plan, you will need to provide your Medicare number and the date that your Medicare Part A and Part B coverage began. You should be able to find this information on your Medicare card.
Keep in mind that plan providers cannot call you to enroll you in a plan unless you ask them to. They also can’t ask you for financial information over the phone. So be careful about which personal information you provide.
If you need help finding affordable health insurance or a supplemental Medicare plan, enter your ZIP code into our free quote comparison tool below.
Case Studies: Medicare Part C Coverage
Case Study 1: WellCare Advantage Plan – Mary’s Journey to Affordable Healthcare
Mary, a 68-year-old retiree, was concerned about the rising costs of healthcare. After research, she enrolled in the WellCare Advantage Plan offered by WellCare Health Insurance Company. This Medicare Part C plan provided comprehensive coverage, including prescription drugs, dental, and vision services.
Mary found the WellCare Advantage Plan to be a cost-effective and convenient option for managing her healthcare needs. With all her healthcare needs covered under one plan, it reduced her out-of-pocket expenses. She also benefited from additional services like routine dental check-ups and discounted eyeglasses.
Case Study 2: Humana Gold Plus – John’s Experience With Extra Benefits
John, a 72-year-old retiree, enrolled in the Humana Gold Plus plan offered by Humana Insurance Company. In addition to standard Medicare Part C coverage, this plan provided extra benefits, including gym membership and a 24/7 nurse helpline. The gym membership motivated John to stay active and maintain his physical well-being, making it particularly helpful for him.
Additionally, having access to a nurse helpline gave him peace of mind, knowing that he could seek medical advice anytime. John’s experience with Humana Gold Plus highlighted the importance of considering the extra benefits offered by Medicare Part C plans when choosing insurance coverage.
Case Study 3: UnitedHealthcare Medicare Advantage – Sarah’s Journey to Personalized Care
Sarah, a 65-year-old retiree, had specific healthcare needs and wanted a plan that offered personalized care options. She opted for UnitedHealthcare Medicare Advantage, provided by UnitedHealthcare Insurance Company. This Medicare Part C plan allowed Sarah to choose her primary care doctor and provided coordinated care through a network of healthcare professionals.
Sarah valued the personalized approach, as it ensured continuity of care and helped her build a strong doctor-patient relationship. The UnitedHealthcare Medicare Advantage plan’s emphasis on personalized care allowed Sarah to receive the attention and medical expertise tailored to her individual health needs.
Frequently Asked Questions
What is Medicare Part C?
Medicare Part C, also known as Medicare Advantage, combines original Medicare Parts A and B and often includes supplemental coverage as well. It is offered by private insurers, and coverage varies depending on the plan.
What does Medicare Part C cover?
Medicare Part C must cover everything that Medicare Part A and Part B cover. Additionally, many plans include prescription drug coverage (Medicare Part D) and offer extra benefits like vision, dental, or wellness programs.
How much does Medicare Part C cost?
The cost of Medicare Part C coverage varies depending on the plan and the insurer. While some plans have no additional premium beyond the Medicare Part B premium, others may have additional costs. The average additional premium is around $60 per month.
What are Medicare Part C networks?
Medicare Advantage plans are organized into networks, such as Health Maintenance Organizations (HMOs) or Preferred Provider Organizations (PPOs). HMOs generally cover in-network providers, while PPOs cover both in-network and out-of-network providers.
Where can I get a Medicare Part C plan?
You can search for Medicare Part C plans using Medicare’s plan finder tool. The tool allows you to compare plans and provides details about each plan’s coverage. You can also enroll online or by filling out an enrollment form.
How can I find affordable health insurance or supplemental Medicare plans?
To find affordable health insurance or supplemental Medicare plans, you can use a free quote comparison tool that allows you to compare quotes from different insurance companies. Enter your ZIP code to get started.
Pros of Medicare Part C:
- Combines Medicare Parts A and B in one plan
- Often includes prescription drug coverage and extra benefits
- Provides coverage beyond original Medicare
- Can offer additional services like vision, dental, and wellness programs
Cons of Medicare Part C:
- Coverage and costs vary depending on the plan and insurer
- Some plans have networks that limit provider choices
- Additional costs may apply beyond the Medicare Part B premium
- Plans may change their coverage and benefits annually
Are you looking for free insurance quotes?
Your one-stop online insurance guide. Get free quotes now!
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Justin Wright
Licensed Insurance Agent
Justin Wright has been a licensed insurance broker for over 9 years. After graduating from Southeastern Seminary with a Masters in Philosophy, Justin started his career as a professor, teaching Philosophy and Ethics. Later, Justin obtained both his Property & Casualty license and his Life and Health license and began working for State Farm and Allstate. In 2020, Justin began working as an i...
Licensed Insurance Agent
Editorial Guidelines: We are a free online resource for anyone interested in learning more about insurance. Our goal is to be an objective, third-party resource for everything insurance related. We update our site regularly, and all content is reviewed by insurance experts.