What is Medicare Part C — Medicare Advantage?

Medicare Part C, more popularly known as Medicare Advantage, is an alternative way for Medicare beneficiaries to receive their Parts A and B services provided by Original Medicare. However, there are two main differences between Original Medicare (Parts A and B) and Medicare Advantage (Part C):

(1) Medicare Advantage is administered by private insurance companies or health systems — not the Federal Government; and
(2) Medicare Advantage may offer additional services that Original Medicare does not, such as routine dental, vision, and hearing benefits, and prescription drug coverage.

So what’s the “advantage” of a Medicare Advantage plan or “MA Plan”? Although you are still responsible for your monthly Part B premium and annual deductible, many MA Plans include prescription drug coverage (in lieu of you purchasing a Part D Plan), as well as routine dental, vision and other additional benefits that are not offered with Original Medicare.  AND those additional benefits and services are provided at little to no additional cost to you!

To be clear, you may not find an MA Plan that includes routine dental, vision, AND hearing services, as well as free transportation to appointments and meals delivered to your home. Why not? Because insurance companies only have so much money to spend on a particular MA Plan to cover costs and expenses, which means that you will likely only be able to find an MA Plan that includes combinations of dental, hearing, vision, etc.

What about the “cons” of an MA Plan?  With an MA Plan, you are usually limited to working with a network of certain primary care physicians, specialists, pharmacies, and hospital facilities.  Thus, if your current PCP, specialist, pharmacy, etc., does not work within the network of the Plan you want to enroll in, you will need to select new options if you proceed.