Summary: What is Medicare: Part C? What does it cover? What does it not cover? What are the costs?

How to Decipher the ABCDs of Medicare: Part C

How to Decipher the ABCDs of Medicare: Part C

Medicare is defined according to (the official site for Medicare) as “the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Failure (permanent kidney failure requiring dialysis or a transplant, sometimes called ERSD)”.

This article is part of a series of articles:

  1. Medicare Overview
  2. Medicare Part A
  3. Medicare Part B
  4. Medicare Part C
  5. Medicare Part D
  6. Medicare Part E? Medicare Supplements

What does Medicare Part C cover?

Medicare Part C is also referred to as Medicare Advantage Plans. Medicare Advantage Plans are a type of Medicare health plan offered by a private company that contracts with Medicare to provide you with Part A and B benefits and may additional provide Part D. Medicare Advantage Plans may include organizations such as: HMOs, PPOs, private fee for service plans, special needs plans, and Medicare Medical Savings Account plans.

Who is eligible for Part C?

In order to be eligible for Part C, you need to be currently enrolled in both Medicare Part A and B plans and not have End-Stage Renal Disease (ESRD).

What is the cost of Part C?

Medicare Part C is a private insurance and the premiums vary by plan. Some of the factors which can affect premiums are:

  1. Whether the plan charges monthly premiums
  2. Whether the plan pays a portion of Medicare Part B premiums
  3. Whether the plan has a yearly deductible
  4. How much coinsurance  and copayments are
  5. The type of services needed and how often they are needed
  6. Whether your doctor accepts assignment
  7. The plan’s yearly limit and out-of-pocket expenses
  8. Whether you have Medicaid as well
  9. The next few articles will delve into each part of Medicare and outline the coverage as well as the costs. Medicare has become very complex and a refresher on exactly which parts cover which areas might help to provide clarification.

Open Enrollment

Don’t forget open enrollment for Medicare is October 15-December 7, 2012. This is your time to make any changes to your Medicare plans as well as enroll in additional plans.


We invite all comments in regard to this article. What are your thoughts on Medicare? What are your thoughts on the Affordable Care Act and Medicare?  Do you think the system is working? Do you think Medicare should be regulated and administered at the individual state level? How will the healthcare insurance exchanges impact Medicare?

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