There are four parts to Medicare coverage. Medicare Part C is a Medicare Advantage policy that replaces Medicare Parts A and B (MA), and in many cases, Part D (MAPD). The Center for Medicaid and Medicare Services (CMS) has allotted a certain amount of funds per beneficiary for coverage. Those funds are transferred to a private company to be the administrator of the
What are the Eligibility Guidelines?
In order to have Medicare Part C, you must first be eligible and enrolled in Medicare Part A and Part B. The only health issue that will keep you from the ability to choose the benefit is if you are in end-stage renal disease.
Additionally, there are some policies that are for veterans only, or for people who are still employed and/or covered under an employer benefit prescription drug plan. There are also policy options that cover people who qualify for both Medicaid and Medicare. The coverage rules, limits, and premiums vary with each policy, and policy options are determined by your zip code.
What Medicare Part C Covers
There are different types of plans and different insurance companies that provide the coverage. Just like employer health insurance, your Medicare Advantage policy might be
You will have a choice between a policy that covers prescription drugs and one that does not. Some companies provide just a basic coverage package, which may have a zero premium. It’s important to note that even if you have a Medicare Part C policy with a zero premium. You will still be responsible to pay the premium for your Medicare Part B.
The most common plans do include prescription coverage, which replace your Medicare Parts A, B and D. It’s very important to note that you cannot have an additional, stand-alone Medicare Part D plan. However, you can have a discount prescription card that is not associated with Medicare coverage.
How Do I Sign Up For Free?
The most common method is to locate an insurance agent in your area that is reputable and has been certified by CMS to sell Medicare Advantage plans. This is often the most comfortable option for seniors as it provides them with someone to help them understand all their options face to face.
Check with your local Area Agency on Aging, as they may provide you with free guidance. There may be other community agencies or organizations that can provide you with guidance or direct you to the right place.
If you know the companies who provide the coverage you want in your area, you can contact them directly; they do not charge a fee.
Lastly, you can go to Medicare.gov. You provide your zip code and your Medicare status. Then you will have the opportunity to put in your medications, including dosage and frequency. Once you make your choice, it will give you a list of Medicare Advantage products in order of suitability.
Ask yourself what coverage is most important and what will your budget allow. Because companies often make changes from year to year, it’s important to review your policy during the open enrollment period. Your local certified agent can navigate all the changes and explain them to you. So that you can be sure each year you are choosing the right coverage.