Medicare Advantage (Part C) Plans

Medicare Part C, also known as Medicare Advantage, is a health insurance coverage option provided by private insurance companies. It offers additional benefits on top of Original Medicare, becoming your primary source of coverage. If you need help enrolling in Medicare Advantage or have questions about these plans, contact Core Value Insurance Group.

As many seniors discover, Original Medicare alone doesn’t always provide everything they’re looking for when it comes to healthcare coverage. While Medicare Part A and Part B offer a strong foundation, they can leave you with out-of-pocket costs, limited coverage for certain services, and the need to manage multiple plans separately. If you want more predictable costs, added benefits, and a simpler way to manage your healthcare, you should consider Medicare Advantage (Medicare Part C).

These plans bundle your Medicare coverage into one convenient option, often with extra benefits beyond what Original Medicare provides. At Core Value Insurance Group (CVIG), we help seniors understand their Medicare Advantage plan options and assist them in enrolling in coverage that aligns with their healthcare needs and financial comfort.

If you’re exploring your Medicare choices, let one of our licensed insurance agents guide you every step of the way. Book a consultation today!

What Is a Medicare Part C (Medicare Advantage) Plan?

A Medicare Advantage plan, also known as Medicare Part C, is an alternative way to receive your Medicare benefits. These plans are offered by private insurance companies that are approved by Medicare and must follow federal guidelines to ensure quality and consistency of coverage.

When you enroll in a Medicare Advantage plan, you receive all the benefits covered under Original Medicare (Part A and Part B) along with additional coverage options. This may include prescription drug coverage (Part D), routine dental care, vision exams, hearing services, wellness programs, and fitness memberships.

Medicare Advantage plans are designed to help simplify healthcare while offering more comprehensive coverage options for seniors who want flexibility and peace of mind.

Medicare Advantage Plan Options

Medicare Advantage insurance plans come in different formats, allowing you to choose a structure that best fits your healthcare preferences. The two most common types are Health Maintenance Organization (HMO) plans and Preferred Provider Organization (PPO) plans.

HMO Medicare Advantage Plans

HMO plans typically require you to choose a primary care physician (PCP) who coordinates your care. This doctor becomes your main point of contact and provides referrals when you need to see a specialist.

HMO plans usually have lower monthly premiums and out-of-pocket costs, making them appealing for seniors who are comfortable receiving care within a defined provider network. It’s important to note that going out-of-network for non-emergency care may not be covered by the plan, except in certain circumstances.

PPO plans offer more flexibility when it comes to choosing healthcare providers. You can see doctors and specialists both inside and outside of the plan’s network, often without needing a referral.

While PPO plans may come with slightly higher premiums or cost-sharing, they can be a great option for seniors who want freedom in selecting providers or who travel frequently. While the coverage for out-of-network services may be lower than in-network services, it can still help reduce your overall expenses if you need to see providers outside of the plan’s network.

Compare Medicare Advantage Carriers

Researching popular Medicare Part C carriers is another crucial step in choosing the right plan. 

Some well-known carriers include Independence Blue Cross, Jefferson Health Plans, United Healthcare, Humana, and many others. Make sure you look into each carrier to ensure they will be reliable partners in providing your healthcare coverage. 

  • Compare their plan offerings to see which ones align with your healthcare needs.
  • Examine their networks of providers to determine if they include your preferred doctors and hospitals. 
  • Consider customer satisfaction ratings and reviews to gauge how well each carrier serves its members. 

Our team at CVIG can help you throughout this entire process of comparing Medicare Advantage (Medicare Part C) carriers.

Medicare Advantage Costs

Understanding the costs associated with Medicare Advantage plans can help you make a confident decision. While Medicare costs vary by plan and location, there are a few common elements to be aware of.

Most Medicare Advantage plans require you to continue paying your Medicare Part B premium. In addition, some plans charge a monthly premium, though many offer low-cost or $0 premium options.

You may also encounter copayments or coinsurance for doctor visits, specialist care, hospital stays, and prescriptions. One of the biggest financial protections Medicare Advantage offers is an annual out-of-pocket maximum. Once you reach this limit, the plan covers 100% of covered services for the remainder of the year.

Comparing costs across plans can feel overwhelming, but you don’t have to navigate it alone. Core Value Insurance Group helps break down Medicare Advantage costs in clear, easy-to-understand terms so you know exactly what to expect.

When Can You Enroll in a Medicare Advantage Plan?

There are specific times during the year when you can enroll in or change a Medicare Advantage plan. Knowing these enrollment periods helps ensure you don’t miss an opportunity to get the coverage you need.

Your initial enrollment period is a seven-month window that begins three months before you turn 65, includes your birthday month, and ends three months after. This is often the first opportunity to enroll in Medicare Advantage if you’re eligible.

The annual enrollment period runs from October 15 to December 7 each year. During this time, you can join, switch, or drop a Medicare Advantage plan. Changes made during AEP take effect on January 1 of the following year.

From January 1 to March 31, seniors who are already enrolled in a Medicare Advantage plan can make a one-time change. This includes switching to a different Medicare Advantage plan or returning to Original Medicare.

Life happens! Fortunately, special enrollment periods allow you to make changes outside of standard enrollment windows due to qualifying life events, such as moving to a new service area, losing employer coverage, or qualifying for certain assistance programs.

A licensed insurance agent can help determine which enrollment period applies to you and ensure your enrollment is completed accurately and on time.

Benefits of Choosing a Medicare Advantage Plan

Why do millions of seniors choose Medicare Advantage over Original Medicare alone? The answer usually lies in the “extras.”

  • Predictable Costs: Many Medicare Advantage plans include annual out-of-pocket maximums, which help protect you from unexpected medical expenses. Original Medicare does not have a cap on out-of-pocket spending, making this feature especially valuable.
  • Bundled Coverage: Instead of managing separate plans for hospital care, medical services, and prescriptions, Medicare Advantage combines everything into one plan with one insurance card.
  • More Options: Many plans also offer additional benefits not covered by Original Medicare, such as prescription drugs, dental cleanings, vision exams, hearing aids, transportation to medical appointments, and wellness programs. These extras can significantly enhance your overall healthcare experience.

How Core Value Insurance Group Helps You Enroll in Medicare Advantage

Navigating Medicare options can feel confusing, especially with so many plans and details to consider. Core Value Insurance Group is committed to making the process easier, clearer, and more comfortable for seniors.

Our licensed agents take the time to understand your healthcare needs, prescriptions, preferred doctors, and budget. We then compare Medicare Advantage plans available in your area and explain the differences in plain language so that you can make an informed decision about your coverage.

Explore Medicare Advantage Plan Options With a Trusted Guide

Choosing a Medicare Advantage plan is an important decision, and having the right guidance makes all the difference. At Core Value Insurance Group, we’re dedicated to helping seniors find coverage that supports their health, financial security, and peace of mind. If you’re ready to explore Medicare Advantage options or simply want answers to your questions, speak with a licensed agent today.

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Frequently Asked Questions

How does Medicare Part C differ from Original Medicare?

Long story, short: Medicare Part C replaces Original Medicare as your primary source of coverage. 

While Original Medicare is administered by the federal government and provides coverage for hospital stays (Part A) and medical services (Part B), it does not typically include prescription drug coverage or other supplemental benefits. 

In contrast, Medicare Advantage plans often include prescription drug coverage (Medicare Part D) as well as additional benefits like: 

  • Dental care
  • Vision exams 
  • Eyewear
  • Hearing aids
  • Fitness programs
  • Transportation services 

These extra benefits can help you save money on healthcare expenses and improve your overall well-being.

Choosing the right Medicare coverage is a personal decision, and Medicare Advantage isn’t a one-size-fits-all solution. If you prefer having a primary care doctor who helps coordinate your care and don’t mind using a network of providers, an HMO plan may be a good fit. If you value flexibility, see multiple specialists, or travel frequently, a PPO plan might better suit your needs.

Yes, you can switch from Original Medicare to a Medicare Advantage plan, as long as you are within an eligible enrollment period. Many seniors make this change during the annual enrollment period (October 15 to December 7) or during their initial enrollment period when first becoming eligible for Medicare.

Are you currently enrolled in Original Medicare and wondering how to switch to Medicare Advantage? A licensed Core Value Insurance Group agent can help you confirm your eligibility and guide you through the switch smoothly.

Whether you can keep your current doctor depends on the plan you choose and whether your doctor is part of the plan’s provider network. HMO plans usually require you to use in-network providers, while PPO plans offer more flexibility to see doctors both in and out of network.

Before enrolling, it’s important to confirm that your preferred doctors, specialists, and hospitals participate in the plan. Core Value Insurance Group helps seniors check provider networks so there are no surprises after enrollment.

Yes. Even if you choose a Medicare Advantage plan with a $0 monthly premium, you must continue to pay your Medicare Part B premium to the federal government. This premium is what allows you to remain enrolled in the Medicare program. Some specific Advantage plans offer a “Part B Buy-Back” or “Give-Back” benefit that pays a portion of that premium for you, and a CVIG agent can help you identify if any of those plans are available in your area.