What is Medicare Part C?
Medicare Part C, more commonly known as Medicare Advantage, allows private health insurance companies like Priority Health to offer Medicare benefits beyond what is covered by Parts A and B. These plans can include Health Maintenance Organizations (HMOs), Point of Service (POS) plans and Preferred Provider Organizations (PPOs).
When these plans include prescription drug coverage from Part D, they are referred to as MAPD plans. In essence, Medicare Advantage plans provide all the benefits of Original Medicare, plus additional features and services.
What does Part C cover?
Coverage under Part C is very similar to that of a typical health insurance plan; however, it also offers dental, vision and other coverage benefits that may not be found in Parts A and B.
Who is eligible?
If a Medicare Part C plan seems like the right choice for you, you can follow the standard application process. However, keep in mind that the usual Medicare enrollment requirements still apply. You must:
- Have both Medicare Part A and Part B to enroll
- Be a permanent Michigan resident and reside in our service area for at least six months of the year
You can't be denied for pre-existing conditions unless diagnosed with end-stage renal disease (ESRD).
When can you enroll?
You can enroll in Medicare Part C during any of the following periods:
Initial enrollment period (IEP). IEP is the seven-month period that begins three months before your 65th birthday and enrollment in Parts A and B. During this time, you can elect to have just Original Medicare (Parts A and B) or add extra coverage with a Medicare Advantage or Medigap plan.
Annual election period (AEP). The annual election period runs from October 15 to December 7 each year. During this time, you can make necessary changes to your supplemental Medicare coverage, reevaluate your current and future health care needs and ensure your plan is a good fit for the upcoming year.
You can also change to a different Medicare Advantage or MAPD (with Part D) plan or return to Original Medicare, provided you were previously enrolled in an Advantage or MAPD plan.
Special enrollment period (SEP). These are periods outside of the IEP or AEP when an individual can change their current plan. Some examples are:
- If you move outside the plan's service area
- If you are enrolled in both Medicare and Medicaid
- If you qualify for a low-income subsidy
- If you lose creditable drug coverage from your employer
- If your plan is no longer offered
- If your plan is terminated by Medicare