- Medicare Part A
- Medicare Part B
- Medicare Part C
- Medicare Part D
Ah, if only Medicare was as simple as A-B-C.
Earlier posts reviewed Parts A (hospital insurance) and B (medical insurance). This post tackles Medicare Part C, known as Medicare Advantage plans.
If you are just joining this journey into Medicare madness, welcome. I started these explanation posts after my dad’s former employer stopped offering a retirement health plan. I helped my mom walk through the Medicare maze.
To say Medicare is complicated is a major understatement. And I have over 30 years in the employee benefits/insurance industry! But, first, my disclaimer.
I am not an attorney or health care provider and cannot provide legal or health care advice. The information provided is for your general background only, and is not intended to constitute legal, insurance or health care advice as to your specific circumstances. I recommend reviewing your options with a qualified insurance adviser.
Yep, I’m simply someone hoping to make your life (or family member’s life) a little simpler when it comes to Medicare.
Ready to move on?
How Medicare Part C Started
Unlike Part A and Part B, Medicare Part C is not about covering specific services (like hospital or medical services). Part C refers to an alternative to the Original Medicare program.
Part C was designed to offer you a choice between the Original Medicare program or one through private insurance. Since its debut in 1999, Part C has had a makeover.
Originally, its name was Medicare+Choice, with the following features.
The Centers for Medicare and Medicaid Services (CMS) contracted with public and private organizations that offered a variety of plans.
- Health Maintenance Organizations (HMOs)
- Preferred Provider Organizations (PPOs)
- Medical Savings Accounts (MSAs)
- Private-fee-for-service (PFFS) plans
- Religious Fraternal Benefit (RFB) plans
The plans offered Medicare Part A (hospital) and Part B (medical) benefits. Most threw in additional benefits beyond Medicare coverage.
Medicare+Choice hit major bumps in the road.
- A lack of plans in rural areas
- Large, regional differences in payment
- A mass departure of participating plans
After some bickering and more legislation, Part C became known as Medicare Advantage plans.
When you first look at Medicare Advantage plans, it seems like a “no-brainer.”
- They offer Part A and Part B
- Most offer drug coverage
- Some include dental and vision benefits
Why not choose that over Original Medicare that just offers Parts A and B?
It’s not that simple. Why do I think you are not surprised?
For people keeping Original Medicare, they also have other options.
- Adding Part D prescription drug coverage
- Selecting Medicare Supplement Insurance (Medigap policy) to fill in some of the holes on Original Medicare coverage
Your options are illustrated below.
It bears repeating. It’s not that simple.
I encountered significant problems for my mom when reviewing Medicare Advantage plans. The choices you make can have a lasting effect.
Let’s keep that discussion for the next post. If you’re like me, you can only take Medicare discussions in small doses. I wonder if that’s covered under Part D.
Rest is a good thing, but boredom is its brother.
Notice of Disclaimer –Cathy Miller is not an attorney or health care provider and cannot provide legal or health care advice. The information provided is for your general background only, and is not intended to constitute legal or health care advice as to your specific circumstances. We recommend you review legislation with legal counsel and visit your physician for health care issues.