MEDICARE ADVANTAGE PLANS (PART C)

Helping People 65+ In New York & Long Island Choose The Right Health Insurance Plans

Though Medicare provides millions of Americans with excellent health benefits, it might not actually cover all the medical care you might need. To provide additional covered services, numerous private insurers offer Medicare Advantage plans, often called Medicare Part C coverage.

Medicare Advantage offers not only standard Medicare, but also other services. That’s extra care you won’t have to worry about paying for alone. Let Senior Healthcare Solutions help you get a plan now!

What’s Medicare Advantage? 

Medicare Advantage plans are private plans offered by major insurance companies with the approval of the government. Think of Advantage plans as something of an enhanced version of Original Medicare, the U.S. government’s insurance program that began in the mid-20^th century.

Original Medicare helps qualifying Americans, usually seniors or the disabled, get health insurance and medical care affordably. It offers two types of coverage:

• Medicare Part A covers costs related to inpatient medical care and surgeries. Nursing home stays, hospice, home health care, and related costs also have coverage under this section.
• Medicare Part B pays for medically-necessary services and routine medical care. Your regular checkup and related care usually have coverage under Part B.

Still, Original coverage does not pay for every type of care. That’s where Medicare Advantage can come into play. They can help you afford care that you might not be able to get with just Original coverage. 

Since Advantage Plans are "insurance company" plans, where Medicare is no longer primary or secondary, you will usually be required to stay within an insurance company's network of doctors and hospitals. It is very important to choose a plan with this in mind.

Premium Prices in New York vary from $0 - $297 per month.

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What is covered under Medicare Part C?

Though they are private plans, Medicare Advantage policies are highly-regulated. Policies must provide you with at least the benefits provided by Original Medicare Parts A & B.

Because these are private plans, any given Advantage plan varies in what additional services they will offer. Still, they often cover services like:

• Vision care
• Dental care
• Prescription drug costs
• Hearing aids and hearing tests

Advantage plans do not replace Original Medicare. You must remain in the Original program to remain eligible for Part C. Certain services, namely hospice care, will also still be covered by Original Medicare, rather than the Advantage plan. Still, your Part C plan will essentially take over for most Original Medicare services as long as you have the policy.

How do Medicare Advantage plans work?

Advantage plans come in many shapes and sizes such as:

• HMOs
• PPOs
• PFFS
• Special-needs Plans (SNPs)
• MSAs

You will essentially use your plan like you would any other health insurance. Policy rules will vary based on the plan you choose.

• You must pay a premium for your coverage.
• Some policies will have deductibles or coinsurance costs.
• You usually must see a doctor who accepts your plan.
• Many Advantage plans include physician networks, which are groups of providers who will cost you the least money to see.

Why do I need Medicare Part C?

Think about how some of the additional Medicare Advantage services (such as dental or vision care) might benefit your health. Getting these services might mean a better wellness outlook for your future. You’ll have a lot more choice to get covered care when you need it most. 

Who qualifies for Medicare Advantage?

Medicare Advantage plans have their own enrollment rules. They usually require:

• You must have both Original Medicare Part A & Part B to qualify for to Medicare Advantage.
• You generally have to buy a policy offered in your area.
• You must be more than 65 years old to get a plan (some younger people can enroll, however).
• You cannot have end-stage renal disease (ESRD).

Plans vary widely, so talk to your Senior Healthcare Solutions agent to determine your unique eligibility.

When is Medicare Advantage enrollment?

There are several times each year when you can enroll in or change your Advantage plan. Most people enroll around their 65^th birthday. We’re happy to explain the specifics of when you can buy, change or drop a plan. Check out the details about enrollment periods.

What is the average cost of Medicare Part C?

Your Advantage policy’s cost will vary based on numerous factors. You also might still have to pay your Original Medicare Part B premium in addition to the Part C premium. We can help you get covered affordably and ensure you are prepared for all your personal costs.

Who do You Call with Medicare Questions?

To get help with all your Medicare Part C questions, call Senior Healthcare Solutions at (631) 539-6351. We can help you get covered today!

You can also contact the Medicare system directly at:

• www.Medicare.gov/forms-help-resources
• National Phone Number: 1-800-MEDICARE (1-800-633-4227)
• TTY Phone: 1-877-486-2048
• Medicare Contact Center Operations
  PO Box 1270, Lawrence, KS 66044

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