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What is Medicare Part C Coverage?

Medicare Advantage Plans (like HMOs and PPOs) are sometimes referred to as Medicare Part C. These are private health plans that have been approved by Medicare to offer health care to people on Medicare through their own networks. When you join a Medicare Advantage Plan, you are still in Medicare.

Medicare Advantage Plans provide all of your Part A (hospital) and Part B (medical) coverage and must cover medically-necessary services. They generally offer extra benefits, and many include Part D drug coverage. These plans often have networks, which mean you may have to see the plan's doctors and go to certain hospitals to get care. Medicare Advantage Plans can save you money, since out-of-pocket costs in these plans are generally lower than with Medicare alone. However, your cost will vary by the services you use and the type of policy you purchase.

Plans options can include:
  • Medicare Preferred Provider Organization (PPO) Plans
  • Medicare Health Maintenance Organization (HMO)
  • Medicare Private Fee-For-Service (PFFS)
  • Medicare Special Needs Plans (SNP)
  • Medicare Medical Savings Account (MSA) Plans
You can generally join if:
  • You live in the service area of the plan you want to join.
  • You have Medicare Part A and Part B coverage.
  • You don't have End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant)
Choose your plan carefully; for the most part you will only be able to change plans once a year, between November 15 and December 31. In certain situations, you may be able to switch plans at other times.