Part C or Medicare Advantage Plans are health insurance plans from Medicare-approved private companies. The insurance providers must follow Medicare guidelines to participate in the program. Medicare Advantage Plans work similarly to typical employer-based insurance. Depending on the policy you select, your coverage may fall under one of the following types of plans:
Health Maintenance Organization (HMO) Plans – HMOs have the least expensive premiums but the highest costs for services. HMO plans also have high deductibles. These plans are better suited for people who do not require many medical services annually.
Preferred Provider Organization (PPO) Plans – PPOs have higher premiums but lower service costs than HMO plans. PPOs give you better control of your medical care since you do not need to select a primary care provider (PCP) to act as your gatekeeper for other services.
Private Fee-for-Service (PFFS) Plans – PFFS plans do not require a PCP and you do not need a referral to see a specialist. Some doctors and medical professionals will not treat you, however, if they are out of your network and do not accept the plan’s terms.
Special Needs Plans (SNPs) – These plans limit enrollment to those who have a specific disease or diagnosis. SNPs tailor benefits to match the needs of the condition, such as drug and service coverage common for that condition.
Review the different Medicare quotes for various coverage types. While the program helps reduce the cost of health insurance, some plans may be more affordable than others. Your health care needs will also affect your medical expenses.
Like Original Medicare, you can sign up once you are eligible. Enroll during your initial enrollment period when you first become eligible or during the open enrollment period from October 15th to December 7th. Note that the open enrollment period of Medicare Part C is different from Medicare Part A and B.
If you are an SSI applicant, representatives will automatically enroll you in Original Medicare. You will need to indicate if you want to enroll in a Medicare Advantage Plan.
You may seek an SSI attorney to assist with applying for benefits and enrolling in Medicare. An SSI lawyer can complete the paperwork on your behalf but cannot guarantee enrollment into either program.
A Medicare Advantage Plan may include prescription insurance. However, review the details of your prospective plan before signing up. If you choose Original Medicare, you will need to sign up for Part D for drug coverage.