Medicare Part C or Medicare Advantage is the optional, alternative way some individuals choose to receive their Medicare Part A and B benefits. When you opt to take a Medicare Advantage plan, you are still responsible for paying for your Part B premium. In addition, you will have the costs associated with your Medicare Advantage plan.
Medicare Advantage plans vary tremendously from state to state, region to region and even county to county. For the sake of discussion, everything in regard to Part C Medicare Advantage is a generalization.
As mentioned above, you will continue to pay your monthly Part B premium. You will then be responsible for paying the premium of the plan that you select. Plan premiums range from $0 monthly to well over $150.00 monthly or more. In many cases, the plans have a $0 or very low monthly premium.
In addition to your monthly plan premium, in most cases, you will pay a copay for most services received under the plan until you reach the plan’s annual “Maximum Out of Pocket” amount or “MOOP”. The MOOP for 2020 is $6700.00, though some plans may have a lower MOOP. This is the most you can pay for all covered services combined under the plan.
Some copays associated with Medicare Part C plans are office visit copays, ranging from $5.00 to $50.00 or more. Chemotherapy typically carries a 20% charge. You may be charged a daily hospital fee of $150.00 to more than $300.00 a day for the first several days of hospitalization. Copays are also typically assessed on outpatient procedures, diagnostics and more. Keep in mind that while these plans are heavy on copays, they do provide an annual “Maximum Out of Pocket” amount to help limit your exposure.
Many Medicare Advantage plans include prescription drug coverage. These plans are called MAPD plans, or Medicare Advantage Prescription Drug Plans. If you do not need drug coverage because you have other coverage such as VA, you can purchase a Medicare Advantage plan or MA only plan.
As you can see, this is just an overview of some of the costs associated with Medicare Part C Medicare Advantage Plans. The actual costs and benefits will vary tremendously from plan to plan and will need to reviewed carefully if you feel this may be the right choice for you.