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Medicare-A Detailed Guide
Part C (Medicare Advantage)

Part C (also known as Medicare Advantage) is a bit of a catch-all plan.  It covers your hospitals and doctors that Part A and Part B cover, and you can choose a Medicare Advantage plan that includes prescription drug coverage if you wish.  This way you won't have to buy a separate Part D policy.

Medicare Advantage pays in lieu of Part A, Part B, and (if chosen), Part D.  The easiest way to think of Medicare Advantage is that instead of the Federal Government

administering your Medicare, you are choosing a private insurance company to administer your health care.  This is a huge benefit that allows you to wrap 3 different health programs (Part A, Part B, and Part D) all into one single health plan.  Additionally, Medicare Advantage plans typically have benefits that Part A and Part B simply don't offer.

What Does Medicare Advantage Cover?: 

Medicare Advantage covers everything that Part A and Part B cover and more.  You can also choose a Medicare Advantage plan that has prescription drug coverage.  If you choose a plan with prescription drug coverage it also covers everything that a separate Part D plan would cover.

Does Medicare Advantage Have The 20% Co-Insurance Like Part B? 

No!  This is one of the greatest benefits of Medicare Advantage.  Instead of being responsible for the 20% co-insurance in Part B you will only have some small co-pays and cost sharing.  To see what your copays for various services are you will want to look into the plan's Summary of Benefits.

How Much Does Medicare Advantage Cost?  

Some Medicare Advantage plans can have a small premium, but generally you will be able to find a variety of suitable plans at a $0 premium.  This means you will only have to pay the $164.90 Part B premium and nothing for your Medicare Advantage plan.

If There Is No Charge, How Is It Paid For? 

Remember, instead of having the government administer your Medicare under 2 or 3 different parts, you are having a private health insurance company administer them all under one plan.  Since the government no longer has to pay claims for Part A and Part B, they forward the Part B premium you are already paying (as well as some of the money you have paid into the system over the years) directly to the insurance company that you choose.

Does Medicare Advantage Have Extra Benefits?   

Yes!  Most Medicare Advantage plans come with a wide array of extra benefits such as dental coverage, vision & hearing coverage, over-the-counter reimbursements, gym memberships, meals and much more.  To see all of the extra benefits you will want to look into the plan's Summary of Benefits.

Does Medicare Advantage Give Money Back To Me? 

Some plans do!  Depending on your zip code and whether or not you elect to take prescription drug coverage, some Medicare Advantage plans give you money back.  This money is typically added to your Social Security check to offset the Part B premium.  For example, if a plan gives you $50 back, you will only be paying $114.90 a month for your Part B premium instead of the full $164.90.  During the Annual Enrollment Period for 2023 we saw plans in some areas giving back $160 leaving the beneficiary to only pay $4.90 a month for the Part B premium.  If you would like to see if there are any plans that give back money in your zip code you can request a callback from one of our experienced agents or you can view plans here.

Author's Opinion

Getting a Medicare Advantage (Part C) plan is far superior than just having Part A and Part B and it is probably the right option for most people.  If you are fairly healthy and you don't use a lot of health care services, a Medicare Advantage plan is the best fit for you.  Once your health gets to a spot where copays and cost sharing starts adding up to be north of $3,000 a year it may be time to look at a Medicare Supplement Policy also known as Medigap insurance.

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