Is Medicare Part C the same as Medicare Advantage?

Asked by: Prof. Kory Schiller Sr.  |  Last update: November 9, 2023
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Medicare Advantage Plans, sometimes called “Part C” or “MA” Plans, are offered by Medicare-approved private companies that must follow rules set by Medicare. Most Medicare Advantage Plans include drug coverage (Part D). There are several types of Medicare Advantage Plans (see page 17).

What is the difference between Medicare Part C and a Medicare Advantage plan?

Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by private companies approved by Medicare. If you join a Medicare Advantage Plan, the plan will provide all of your Part A (Hospital Insurance) and Part B (Medical Insurance) coverage.

Can you get Medicare Part C without an Advantage plan?

Medicare Part C Eligibility. To be eligible for Medicare Part C, you must be enrolled in Medicare Part A and Part B, and be a resident of the Medicare Advantage plan's service area.

What is the advantage of having 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.

What is Medicare Part C and what does it cover?

Medicare Advantage (MA), also called Medicare Part C, are private insurance plans offered by Medicare-approved companies. Medicare Advantage plans provide most of Part A (Hospital Insurance) and Part B (Medical Insurance) coverage and typically offer extra benefits such as vision, hearing and dental care .

Original Medicare vs Medicare Advantage (Part C)

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Why doesn t everyone get Medicare Part C?

In general, a person must meet two eligibility requirements to qualify for Medicare Part C: They must already have enrolled in Original Medicare (Medicare Parts A and B). They must live in an area where an insurance provider offers a Medicare Advantage (Part C) plan with the coverage that they require.

What type of program is Medicare Part C?

Medicare Advantage Plan (Part C)

A type of Medicare-approved health plan from a private company that you can choose to cover most of your Part A and Part B benefits instead of Original Medicare. It usually also includes drug coverage (Part D). Refer to Medicare glossary for more details.

What is the average cost of Medicare Advantage Part C?

The cost of a Medicare Part C (also called Medicare Advantage) plan can be quite low relative to the cost of other types of health insurance. The MedicareAdvantage.com Best States for Medicare in 2023 report found the average Medicare Part C cost is $17.60 per month for plans that include prescription drug coverage.

How do I add Part C to my Medicare?

After you are enrolled in Medicare Part A and Part B, you can select other coverage options like a Medicare Advantage plan from approved private insurers. After this period has ended, you can add or change your coverage during the Open Enrollment Period.

How popular is Medicare Part C?

Medicare Part C has been gaining popularity, and about 45% of all Medicare beneficiaries are enrolled in Part C rather than Original Medicare. Medicare Part C plans must follow certain federal guidelines in terms of services that must be covered and out-of-pocket limits.

What doesn't Medicare Part C cover?

Although insurers are allowed to cover more services than Original Medicare does, not all Part C plans pay for routine dental care, hearing aids, or routine vision care. If you are in need of inpatient care, Medicare Part C may not cover the cost of a private room, unless it's deemed medically necessary.

Is there an income limit for Medicare Part C?

If your income is above a specific limit, you pay higher monthly rates for both Medicare Part B and Medicare Part D. Medicare Part A and Part C rates are not based on income. In 2023, your costs for Medicare Parts B and D are based on income reported on your 2021 tax return.

Can I enroll in Medicare Part C anytime?

Sign up for a Medicare Advantage Plan (with or without prescription drug coverage) or a Medicare Prescription Drug Plan. During the 7‑month period that starts 3 months before the month you turn 65, includes the month you turn 65, and ends 3 months after the month you turn 65.

Is Medicare Advantage better or worse?

For many seniors, Medicare Advantage plans can work well. A 2021 study in the Journal of the American Medical Association found that Advantage enrollees often receive more preventive care than those in traditional Medicare. But if you have chronic conditions or significant health needs, you may want to think twice.

Can you go back to Medicare from an Advantage plan?

If you joined a Medicare Advantage Plan during your Initial Enrollment Period, you can change to another Medicare Advantage Plan (with or without drug coverage) or go back to Original Medicare (with or without a drug plan) within the first 3 months you have Medicare Part A & Part B.

What is cheaper Medicare Supplement or Medicare Advantage?

Specifically, Medicare Advantage plans could cost between $0 and $100 a month, while Supplement coverage may vary between $50 and $1,000 per month. Although Medicare Supplement costs more in premiums, you'll find there are usually few or no out-of-pocket costs.

Am I automatically enrolled in Medicare Part C?

If you want to enroll in Medicare Part C (also known as Medicare Advantage), an alternative to Part B that is provided by private insurers, you must sign up on your own. The same goes for Medicare Part D, prescription drug coverage.

Is Part C of Medicare a supplement?

Medicare Advantage plans do not replace Medicare and are not a Medicare Supplement plan, either. Part C plans provide an alternative to Original Medicare (Part A [hospital] and Part B [medical]) and can offer additional coverage, including prescription drug coverage and extra programs and services.

What funds Medicare Part C?

Medicare Part C — also known as Medicare Advantage — is funded by Medicare Parts A, B and D as well as monthly premiums enrollees pay for their plan.

What is the monthly cost of Medicare Part C?

Our experts at 1-855-915-0881 TTY 711 can help you find the right plan. A Medicare Part C plan costs an average of $28 per month. These bundled plans combine benefits for hospital care, medical treatment, doctor visits, prescription drugs and frequently, add-on coverage for dental, vision and hearing.

How do you qualify to get $144 back from Medicare?

To qualify for the giveback, you must:
  1. Be enrolled in Medicare Parts A and B.
  2. Pay your own premiums (if a state or local program is covering your premiums, you're not eligible).
  3. Live in a service area of a plan that offers a Part B giveback.

What is an example of Medicare Part C?

Medicare Part C may offer other perks too, such as: Fitness benefits, including gym memberships and exercise classes. Routine dental care, including cleanings, X-rays, and dentures. Routine vision care, including contacts and eyeglasses.

Is it necessary to have a Medicare supplement?

Medicare supplement plans are optional but could save you big $$$ on doctor bills. Your cost-sharing under Part B is similar. You are responsible for paying your Part B deductible, which is $226 in 2023. Then Part B Medicare only pay 80% of approved services.

How often can you change Medicare plans?

If you enroll during your Initial Enrollment Period, you can also make changes anytime in the first 3 months of your Medicare coverage. “After that, you can switch plans during open enrollment in the Fall or during Medicare Advantage open enrollment, which is at the beginning of each year,” Dworetsky says.