Medicare has a third Medicare Part Ccalled Part C.  However, A + B doesn’t necessarily = C.  The reason for this is that Part C replaces A and B.  This is where the term “Medicare Advantage” comes from.  One has to consider more than price when it comes to these plans among other things, as everything you read so far for Part A and Part B are not the rules of Part C.

Part C Made Simple

  • These plans are offered by private companies approved by Medicare
  • These plans are not standardized and change every year.
  • Plans are optionally renewable every year by the company–there are situations where you may not re-enroll.
  • These plans replace Part A and Part B, and sometimes include prescription coverage.
  • With Parts A and B, there are no networks, but Part C has networks akin to group coverage we’re used to while working.
  • There are different rules on how hospital and nursing home care are covered.
  • You have co-payments and deductibles rather than cost sharing.
  • You can NOT get a supplement if you are on Part C, so you definitely have to consider how all out of pocket costs will be met.

If you are considering a Medicare Advantage plan, since they are not standardized, you must really consider all that is covered and not just the price.  Some of the most attractive prices have very little coverage–so you can pay more in the long run.

Further notes

Also, it’s good to note that the funding of Medicare Advantage plans by the US Government is shrinking each year.  This means that the cost difference is put (for the most part) onto the subscriber.  My wife, for example, is on a Medicare Advantage plan (disability).  The premium went down this year, but her network shrank, her medication prices went up at our home pharmacy (don’t know if this plan caused it or the pharmacy, to be fair), and coverage is lower.  This, of course, is one company and should not be considered a blanket practice until you research the actual company.

More detail cannot be found on Medicare.gov.  Instead, you must seek out information directly from each company.

Next up, Part D!