What is Medicare Part C?
Medicare Advantage is also known as Part C. It serves as an alternative to original Medicare coverage. While Medicare Part A and Part B are offered by the government through CMS, Medicare Advantage plans are sold by private insurance companies that have gotten the approval from Medicare to offer plans to customers.
Medicare Advantage plans in Washington are a way to receive Part A and Part B and Part D coverage under one plan.
Medicare Part C providers are required to cover all services under Part A and Part B. Additionally, many Part C plans offer certain benefits that are not available under Original Medicare, such as prescription drug coverage, routine dental, vision, and hearing.
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All you pay for is the premiums, which are the same with or without our help.
Do I still show my Medicare ID card when I go to the doctor?
No, when you are enrolled in a Medicare Advantage plan you are no longer seen as covered under Medicare but instead the Medicare Advantage plan becomes your primary coverage. You will only show your MedAdvantage ID card when you go to your providers. You must continue to stay enrolled in Medicare Part A and Part B. You will need to keep paying your Part B premiums.
Where are MedAdvantage Plans Offered?
In Washington, Medicare Advantage plans vary by county. Your friend in Snohomish County may have different plans available for them to choose from compared to you living in Whatcom County. In order to enroll in an Part C Medicare Advantage plan you must live in the service area.
Types of Medicare Advantage Plans
Medicare Advantage plans in Washington can be HMOs, PPOs, PFFS, SNPs, etc. HMO (Health Maintenance Organization) plans offer healthcare coverage that is restricted to providers that are within the plan’s network. Enrollees need to use their benefits in the plans network and need to get referrals for specialists.
Preferred Provider Organization Plans (PPO) gives more freedom to their enrollees compared to HMO plans. Under PPO plans, you can receive healthcare services from out of network providers, though it will cost you more. Special Needs Plans (SNPs) are restricted to beneficiaries with certain health conditions.
Medicare Advantage Hot Tips
- Make sure your providers are in-network
- Make sure your RX are covered under the formulary
- You may be paying a low monthly, but what is the cost when you need to use the plan? What is the Max out of Pocket?
- Will you be traveling? Does the plan have in-network providers in the areas you are traveling to?
Medicare Advantage plans can be available for a very low premium. In some areas there are $0 plans. Even though the premium is low you will want to look at the costs of the services to make sure you can afford to use the plan in case you have a significant health issue.
How to Enroll in a MedAdvantage Plan
Local help matters. We are a Washington insurance agency. Our agents know and understand the networks and plan options in our area. Call today to have one of our brokers help review if a Medicare Advantage is the right choice for you.