Medicare Part C, also called Medicare Advantage, is an insurance option for people who are eligible for Medicare. These plans are offered through private insurance companies.
You don’t need to buy a Medicare Part C plan. It’s an alternative to original Medicare that offers additional items and services. Some of these include prescription drugs, dental, vision, and many others.
To be eligible for a Medicare Part C (Medicare Advantage) plan:
- You must be enrolled in original Medicare (Medicare parts A and B).
- You must live in the service area of a Medicare Advantage insurance provider that’s offering the coverage/price you want and that’s accepting new users during your enrollment period.
To enroll in original Medicare (to be eligible for Part C), in general, you must qualify by:
- Age. You must be at least age 65 or older and a U.S. citizen or legal permanent resident for a minimum of 5 contiguous years.
- Disability. If you’ve received monthly Social Security or Railroad Retirement Board (RRB) disability benefits for 24 months, you’re eligible for Original Medicare. If you’re a disabled federal, state, or local government employee who’s not eligible for monthly Social Security or RRB benefits, you may be deemed entitled to disability benefits and automatically entitled to Part A after being disabled for 29 months.
- ALS. If you’ve received a diagnosis of amyotrophic lateral sclerosis (ALS), you become eligible for Medicare immediately upon collecting Social Security disability insurance (SSDI) benefits (5 months following the classification of “disabled”).
- ESRD. If you have end stage renal disease (ESRD), you’re eligible for Medicare with coverage that could start as soon as your first month of dialysis treatment.
Enrollment into Medicare is time-sensitive and should be started roughly 3 months before you turn age 65. You can also apply for Medicare on the month you turn age 65 and the 3 months following your 65th birthday — although your coverage will be delayed.
If you miss the initial enrollment period, Medicare’s open enrollment period is another chance to sign up for a Medicare plan. This period runs from October 15 through December 7 every year.
Finally, there’s also the Medicare Advantage open enrollment period. This is from January 1 to March 31 each year. However, this period only lets you make changes to your plan if you’re already enrolled in a Medicare Advantage plan.
A Medicare Advantage plan is offered by a private insurance company that’s been approved by Medicare.
These plans combine your original Medicare Part A (hospital insurance) with Medicare Part B (medical insurance).
Often, they also include Medicare Part D (prescription drug coverage) and other benefits, such as vision and dental coverage.
There are many different companies offering Medicare Advantage plans. Each offers different levels of coverage and monthly premiums. Many are Preferred Provider Organizations (PPOs) or Health Maintenance Organizations (HMOs).
At a minimum, these plans will replace Medicare parts A and B, while offering a minimum of all of the benefits provided by parts A and B as required by law.
Medicare Part C (Medicare Advantage) plans are an optional alternative to original Medicare.
To qualify for Medicare Part C, you must be enrolled in both Medicare parts A and B. You also must be living in the desired Medicare Advantage plan’s service area.