Is Medicare Part C the same as advantage?
Asked by: Dr. Alejandrin Dicki | Last update: January 9, 2026Score: 4.2/5 (59 votes)
What is the difference between Part C and Medicare Advantage?
Traditional Medicare (also called Original Medicare) includes Medicare Part A and Part B, which give you inpatient and outpatient coverage. The difference with Medicare Advantage plans (Part C) is that they include Part A and Part B coverage, plus much more.
Why are people leaving Medicare Advantage plans?
But there are trade-offs. Medicare Advantage plans often have a limited network of hospitals and physicians. And while the premiums are typically low, enrollees could end up paying more in the long run in copays and deductibles if they develop a serious illness.
Why would someone want Medicare Part C?
Medicare Part C provides more coverage for everyday healthcare including prescription drug coverage with some plans when combined with Part D. A Medicare Advantage prescription drug (MAPD) plan is when a Part C and Part D plan are combined. Medicare Part D only covers prescription drugs.
Can I get Medicare Part C for free?
The cost of Medicare Part C plans (also known as Medicare Advantage plans) varies depending on where you live and the plan you choose. Some plans have $0 monthly premiums. You still have to pay your Part A and Part B monthly premiums.
What Does Medicare Part C Cover? | Medicare Advantage
Why do people say not to get a Medicare Advantage plan?
Disadvantages of Medicare Advantage plans can include difficulty switching out of the plans later, restrictions on care access, limited provider networks, and limitations on extra benefits.
What is the two midnight rule for Medicare Advantage?
The two-midnight presumption directs medical reviewers to select Original Fee-for-Service Medicare Part A claims for review under a presumption that hospital stays that span two midnights after an inpatient admission are reasonable and necessary Part A payment.
What are the top 5 medicare supplement plans?
💬 From our Nerds: What are the top five Medicare supplement plans? "Based on NerdWallet's Medigap rubric, I picked five best Medicare Supplement Insurance companies for 2025: AARP/UnitedHealthcare, Mutual of Omaha, State Farm, Anthem and Blue Cross Blue Shield.
Why are hospitals refusing Medicare Advantage plans?
Among the most commonly cited reasons are excessive prior authorization denial rates and slow payments from insurers. In 2023, Becker's began reporting on hospitals and health systems nationwide that dropped some or all of their Medicare Advantage contracts.
What is the biggest disadvantage of the Medicare Advantage plan?
Medicare Advantage Plan Pros And Cons
One disadvantage is that some Medicare Advantage plans may offer fewer options when it comes to doctors and hospitals, as they may have smaller plan networks than Original Medicare.
Why are seniors losing Medicare Advantage plans?
Health systems and hospitals are also making the decision to cancel contracts due to excessive prior authorization denial rates and slow payments from insurers. Already 27 health systems have canceled their Medicare Advantage contracts this year.
What are the 6 things Medicare doesn't cover?
- Eye exams (for prescription eyeglasses)
- Long-term care.
- Cosmetic surgery.
- Massage therapy.
- Routine physical exams.
- Hearing aids and exams for fitting them.
What is the disadvantage of UnitedHealthCare for seniors?
Cons About UnitedHealthcare Medicare Advantage
You may only have access to certain HMO or PPO plans in your area. And while UnitedHealthCare has competitive pricing, your location may only have access to plans with higher deductibles, more copays, and fewer additional benefits.
What is the Medicare 85% rule?
Medicare pays for medical and surgical services provided by PAs at 85 percent of the physician fee schedule. This rate applies to all practice settings, including hospitals (inpatient, outpatient and emergency departments), nursing facilities, homes, offices and clinics. It also applies to first assisting at surgery.
Can you be dropped from Medicare Advantage?
Medicare Advantage plans may discontinue your Medicare Advantage coverage if you don't pay your premium within the grace period allowed by the Medicare Advantage plan.
What are the new medicare advantage rules for 2024?
In 2024, the out-of-pocket limit for Medicare Advantage plans may not exceed $8,850 for in-network services and $13,300 for in-network and out-of-network services combined. These out-of-pocket limits apply to Part A and B services only, and do not apply to Part D spending.
Does Medicare Part C pay 100 percent?
Medicare Advantage Plan (Part C):
Deductibles, coinsurance, and copayments vary based on which plan you join. Plans also have a yearly limit on what you pay out-of-pocket. Once you pay the plan's limit, the plan pays 100% for covered health services for the rest of the year.
Does Medicare Part C cover dental implants?
Medicare Advantage plans (Part C) offer a broader range of benefits, and some may include implant coverage. However, benefits and costs differ between plans, so it's essential to review options carefully. If implants aren't covered, alternative solutions like dental insurance or discount programs can help offset costs.
Why do the elderly need Part C of Medicare?
Medicare Advantage (also known as Part C) allows older adults to get their Medicare benefits through private plans. In other words, if you have Medicare Advantage, you still have Medicare; you just receive your Part A and Part B coverage a different way.
What is the best medicare plan that covers everything for seniors?
Original Medicare with Medigap likely offers the most comprehensive coverage, but it may also be the most costly. A person can consider their income and how much they are able to spend before choosing a Medicare plan. Original Medicare with Medigap also offers a lot of flexibility when choosing a doctor or specialist.
Why do doctors not accept Medicare Advantage plans?
The most common reason that doctors may discontinue their acceptance of Medicare Advantage is that the private insurance company makes it difficult or time-consuming for the doctor to get paid for their services.
Why is a plan G better than an Advantage plan?
Medigap Plan G offers more comprehensive benefits than the Medicare Advantage plan and is more widely available. It also provides more freedom for enrollees. For example, a Medigap Plan G enrollee can visit a specialist without a referral.