FAQ Friday: What is Medicare Part C?

Medicare Part C is also known as a Medicare Advantage Plan, which is not a Medicare Supplement. It is a private alternative to Medicare. If you have a Medicare Advantage Plan, your Medicare Part B premium will go to the carrier that you have your plan with instead of Medicare and this is why there are very low or zero premium plans. As far as coverage, the Medicare Advantage does not work like a Medicare Supplement. It does not cover the 20% that Medicare does not cover. Medicare Advantage Plans replace what Medicare Parts A and B would charge with their own set of co-pays, deductibles and co-insurance.

Because Medicare Advantage Plans replace your Medicare, you can no longer go to any doctor or hospital that you choose. Most Medicare Advantage Plans (HMO plans) have a network of doctors and hospitals that you must choose from, however some plans such as PPO plans will allow you to choose any doctor or hospital that you want but you will have to pay more for their services.

What is nice about a Medicare Advantage Plan is that they protect you from the 20% that Medicare doesn’t pay with an annual maximum of out pocket. The national average maximum of pocket for an HMO plan is going to be around $6,700 and around $10,000 for a PPO plan.