Medicare Advantage plans must cover all the same services at Part A and B. Medicare Part C also provides more coverage than Original Medicare. Most of the plans also have prescription drug, dental, vision and hearing coverage. These plans are similar to group or employer insurance.
To qualify for Medicare Part C plans, you must have enrolled in Original Medicare. Even if the Medicare Advantage plan you select does not have a monthly premium, you will still need to pay the standard Part B premium.
Original Medicare has national coverage. You can receive covered care from any health care professional that accepts the insurance.
Medicare Part C plans are regional, however, and you will need to live in the area to enroll in coverage.
If you sign up for Part C, you must go to a provider who is in your plan’s network. Services from in-network providers will typically have a fixed copayment, such as $10 per visit.
However, your insurance provider may not cover out-of-network providers leaving you with out-of-pocket expenses. You also need to get a referral to see specialists with these plans.
For payment of medical expenses by your health insurance, you may need to obtain prior authorization.
You may not qualify for reimbursement without it. Then, you will need to pay for services as if you had no insurance, which can be very expensive.
Can you get prescription drug coverage from Medicare? Learn how Medicare Part D (drug coverage) works and more up next.