Get help choosing your California Medicare Supplement
Toll Free: 1-888-806-3299

Part C Advantage

Medicare Advantage – Part C

Part C Advantage

Part C

Advantage plans are also called Part C. They are not the same Original Medicare, but instead area cost-effective alternative. You will still have the same rights as those on Original Medicare If pick this option. You would receive all of your services from the Part C you choose. Medicare Advantage plans provide the services that Original Medicare does. They tend to provide a lot of additional benefits like routine vision exams, dental care, misc. preventive care, and hearing aids.

How can some of these plans be $0 per month?

These Part C plans renew with Medicare each year. Advantage plans are paid an amount for each member every month. That payment is revised each year and is different in every county. That’s  why it’s possible for plan can offer a plan for $0 monthly premium and small copays.

What do California Medicare Advantage plans cost?

It’s different in every county and there are some plans that charge a monthly fee. In 2014 expect somewhere between $206 and $0 depending on county. Copayments, office visits and different tests and other services are common. Deductibles are not very common with these plans but beginning last year each plan is required to have a maximum out of pocket limit to protect members.

Can I join a plan and just forget about Part A & B?

That would be nice, but you have to be enrolled in Medicare Parts A and B in order to join a California Medicare Advantage plan.

What about my preexisting conditions?

You cannot be refused enrollment if you have a preexisting condition. The one exception is people who have been diagnosed with ESRD(kidney failure). If someone is already on a plan and develops this condition they will not be dis enrolled.

What times of the year can I join?

There are several different times of the year when you can join a plan. The Initial Coverage Election Period (ICEP) is the most common. This period starts three months prior to turning 65, the month you were born, and the three next months. Another time you can join is the Annual Election Period which is Oct 15 – Dec 7.  If you just moved into or out of California you have the right to change to a plan in that state and county.

Are prescriptions covered?

Most plans have Part D prescription drug coverage. In the rare instance that a plan does not include drug coverage it is not possible to purchase a standalone Part D plan.

What’s an Advantage HMO?

This term is for Health Maintenance Organizations. Doctors and hospitals that are contracted with a specific plan are the only doctor’s that can be seen by members. It’s necessary to choose a PCP (primary care physician).  You need to see your PCP for any referrals specialists. If you have an emergency or need urgent care you don’t need a referral.

What about the doctor’s I see now?

If your current physicians don’t take the plan you join you will need to select doctors that do. The only way you could still see them is to pay 100% of their charges. Using your original Medicare card won’t work either.

Some things to consider

Are your current doctors in the plans network? Will they take other plans? What’s the cost if you see doctors that are not in- network? Which drugs are on the formulary and at what copays? Each plan has a list of medicines that are covered called a formulary. This list provides the copay amounts. Need help figuring out what your options are? Just call 1-888-806-3299

Click Here to learn about Medicare Part A

Click Here to learn about Medicare Part B

Click here to learn About Medicare Part D

Click here to learn about Medicare Supplements