BY ONLINEINSURANCE.PRO

Medicare Advantage (Part C) combines Parts A, B, D and extra benefits -- such as dental, eye, hearing etc.

Part C is Medicare Advantage

If you have Part A and Part B, you can join a Medicare Advantage Plan, sometimes called “Part C” or an “MA plan.”

This type of Medicare health plan is offered by Medicare-approved private companies that must follow rules set by Medicare. 

Most Medicare Advantage Plans include drug coverage (Part D).

Bundled Plans

Medicare Advantage is a Medicare-approved plan from a private company that offers an alternative to Original Medicare for your health and drug coverage. These “bundled” plans include Part A, Part B, and usually Part D.

Extra Benefits

In most cases, you’ll need to use doctors who are in the plan’s network. Plans may have lower out-of-pocket costs than Original Medicare. 

Plans may offer some extra benefits that Original Medicare doesn’t cover; like vision, hearing, and dental services.

Before Joining a Medicare Advantage Plan

Talk to your employer, union, or other benefits administrator about their rules before you join a Medicare Advantage Plan. 

In some cases, joining a Medicare Advantage Plan might cause you to lose your employer or union coverage. If you drop or lose employer or union coverage for yourself, you may also lose coverage for your spouse and dependents. You may not be able to get this coverage back.

Insurance Companies Can Decide

Insurance companies can decide if a plan will be available to everyone with Medicare in a state, or only in certain counties. Insurance companies may also offer more than one plan in an area, with different benefits and costs. Each year, insurance companies can decide to join or leave Medicare.

If a plan decides to stop participating in Medicare, you’ll have to join another Medicare health plan or return to Original Medicare.

A Real World Example

Mr. Johnson joined a Medicare Advantage Plan that only serves members with both Medicare and Medicaid. If Mr. Johnson loses his Medicaid eligibility, Medicare requires Mr. Johnson's plan to disenroll him unless he becomes eligible for Medicaid again within the plan's grace period.

The grace period is at least one month long, but plans can choose to have a longer grace period. If you lose eligibility for the plan, you'll have a Special Enrollment Period to make another choice.

Special Enrollment

This Special Enrollment Period starts when your Medicare Advantage Plan notifies you that you're no longer eligible for the plan. It continues during the plan's grace period.

If you're disenrolled from the plan at the end of the grace period, it continues for 2 months after your coverage ends. It's very important to review your coverage options at this time to make sure you continue to have the Medicare health and prescription drug coverage you want.

For more information, see Medicare.gov