Medicare Part C Coverage | Part C Costs | Medicare Made Clear

Medicare Part C is also called Medicare Advantage. It’s an alternative to Original Medicare (Parts A and B).

Medicare Advantage plans are offered by private insurance companies approved by Medicare. You must be enrolled in both Part A and Part B to join a Medicare Advantage plan. You’ll still be in the Medicare program, but you will receive your benefits through the plan instead of through Original Medicare.

What Does Medicare Part C Cover?

Medicare Advantage (Part C) plans combine coverage for hospital care, doctor visits and other medical services all in one plan. Plans are required to provide all of the benefits offered by Medicare Parts A and B (except hospice care, which continues to be provided by Part A). Many plans also provide prescription drug coverage and additional benefits like routine dental and eye care.

What does Medicare part C cover

If you're worried about out-of-pocket Medicare costs...

Medicare Advantage (Part C) plans are required by law to put a cap on out-of-pocket spending for plan members.

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What Does Medicare Part C Cost?

Each Medicare Advantage (Part C) plan sets its own specific costs, but the types of costs they include are similar. The table below shows the types of costs that plans may apply, but you need to look at the details of a particular plan for actual costs.

Premium
Per month Plan premiums vary. You still pay the Part B premium to Medicare (and the Part A premium, if you have one). 
Deductible
Per year  Some plans charge an annual deductible, and some don’t. Part A and B deductibles do not apply. 
Co-Payment
Most medical services, such as doctor visits  Many plans charge co-pays for the services and benefits you use. 
Co-insurance
Select items, such as durable medical equipment  Plans set their own co-insurance terms and percentages

How Medicare Advantage Cost Sharing Works

Most Medicare Advantage plans use a combination of deductibles, co-insurance and co-pays to share the cost of the services you use. Cost-sharing usually applies to all of the services the plan covers.

You need to read the details of each individual Medicare Advantage plan to get the full story on its costs. Most plans have network doctors and pharmacies that may offer plan members discounted pricing.

The following stories may help you understand how cost sharing might work with a Medicare Advantage plan in different situations.

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