LeClair Financial Services, LLC

Medicare Part C and Medicare Advantage plans are two names for the same thing. They are offered by private insurance companies approved by Medicare to provide Part A and Part B benefits on Medicare’s behalf. A Medicare Advantage plan replaces Original Medicare, no bills go to Medicare, only to the private insurance company, but the Advantage plan companies must follow the rules set by Medicare.

You usually have a low premium—or sometimes a $0 premium—but you also have copays and/or co-insurance along the way as you utilize services. Each Medicare Advantage Plan can charge different out-of-pocket-costs for services.

Medicare Advantage plans may offer extra coverage like vision, hearing, dental and wellness programs. Most include Medicare prescription drug coverage (Part D). Unlike Original Medicare, with a Medicare Advantage plan you are usually protected with a max-out-of-pocket amount, or a worst-case scenario for the year.

Medicare Advantage Plans usually have a network of providers that belong to the plan. Some of the networks are HMOs (Health Maintenance Organizations) and some are PPOs (Preferred Provider Organizations). Different networks have different rules you must follow to access and receive services and supplies.