Medicare Part C Eligibility
If you’re interested in Medicare coverage, but aren’t sure which type is right for your needs and lifestyle, there are a few options to consider.
Under certain circumstances, Medicare Advantage (also referred to as Medicare Part C or MA plans) may be an affordable option that provides more coverage than Original Medicare.
Medicare Part C Eligibility Requirements
To qualify for Medicare Part C, an individual must:
- Be enrolled in Medicare parts A and B.
- Be living in the desired MA plan’s service area.
- Pay their Part B premium.
Have credible prescription drug coverage (either through your desired MA plan, or through Medicare Part D).
Some things just shouldn’t be so difficult. Choosing a Medicare plan is one of them.
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How Medicare Part C Works
Who offers Medicare Part C?
Medicare Advantage plans are offered by private companies that are approved by Medicare. Medicare Advantage plans are primarily HMOs (health maintenance organizations), and sometimes PPOs (preferred provider organizations).
What does Medicare Part C cover?
Besides hospice care, they cover everything Original Medicare (Part A and Part B) covers and more. Click here to get a complete breakdown of Medicare Part C coverage.
Where does Medicare Part C provide coverage?
Coverage varies depending on where you live. Not all plans are available everywhere.
When can I sign up for Medicare Part C?
Medicare Advantage plan benefits change year-to-year. Here are the enrollment periods to be aware of for MA plans:
- Your initial enrollment period (IEP), 3 months before and after your 65th birthday. This is usually when most sign up for Original Medicare for the first time.
- The Annual Enrollment Period (AEP), October 15 – December 7. This is when most make changes to their existing plans or sign up for an MA plan for the first time.
- The Open Enrollment Period (OEP), January 1 – March 31. This period is an opportunity to make a one-time change to a current MA plan.
Why could an MA plan be a good option compared to Medigap?
While both Medicare Advantage and Medigap plans help offer supplemental coverage that’s lacking from Original Medicare, Medigap insurance plans do no not cover long-term care, hearing, vision, dental or prescription drug coverage. Many Medicare Advantage Plans may offer additional benefits.
If you want a wider range of coverage, an MA plan may be an option to meet your needs.
How do I pay for Medicare Part C?
Costs included with Medicare Part C include:
- Medicare Part B premium ($164.90 a month in 2023)
- Medicare Part C premium (varies by plan)
- Copayment costs (varies by plan)
- Annual deductible
The good news about Medicare Advantage plans is that there’s a maximum out-of-pocket limit for enrollees ($8,300 for in-network services 2023).
More Options Under One Convenient Plan
At AGA Medicare Options, we’re committed to helping Medicare beneficiaries explore all their plan options. That way, you can make a sound decision about what’s right for you.
We’re more than just face-to-face agents; we help you find peace of mind in your Medicare care.
AGA’s team of highly experienced independent insurance agents have undergone hundreds of hours training and are fully certified to make sure that, no matter where in America, our clients can receive personalized service met specifically around their unique needs.