Medicare Part C

Understanding Medicare Part C (Medicare Advantage)

Medicare Part C, also known as a Medicare Advantage Plan, is offered by private insurance companies approved by Medicare. These plans include all the benefits of Part A and Part B, and most also include Part D prescription drug coverage. Many plans add benefits such as dental, vision, and hearing.

What to Know About Medicare Part C

Costs and coverage vary by plan and location. Each plan may have its own premiums, deductibles, copayments, and provider networks. A key feature is the annual maximum out-of-pocket limit for medical services. Once you reach the limit, you pay nothing for covered medical services for the rest of the calendar year. Prescription drug costs under Part D are not included in that medical out-of-pocket maximum.

Things to Consider

• Provider Networks: Make sure your preferred doctors and hospitals are in-network.
• Prescription Drug Coverage: Review the formulary to ensure your medications are covered.
• Plan Costs and Benefits: Compare premiums, copays, deductibles, and extras.
• Annual Plan Changes: Plans can change costs, benefits, and networks each year.

Enrollment Periods for Part C

• Initial Enrollment Period (IEP): A 7-month window around your 65th birthday.
• Annual Enrollment Period (AEP): October 15 – December 7 each year.
• Special Enrollment Periods (SEPs): Triggered by qualifying life events.

Need Help Navigating Medicare?

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