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Medicare Advantage

Medicare Advantage
Part C

Medicare Advantage, or Part C, is distinct from Original Medicare and is offered by private insurance companies. This means that you have the option to opt for this coverage on top of Original Medicare. An Advantage plan includes (but is not limited to):

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  • All of the Benefits of Original Medicare

  • Long-Term and Custodial Care Not Available Under Original Medicare

  • Dental, Vision, and Hearing Care

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Prescription drugs are often covered under Part C plans. Because Medicare Advantage is offered privately, this availability may change depending on your location. If your plan does not cover prescriptions, you also have the option to add a Part D drug coverage plan.

Coverage

Coverage

Medicare Advantage provides additional coverage to Original Medicare. Because individual providers offer it, your coverage options may change depending on the plan you choose and your location. You will very likely have coverage for: 

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  • Routine dental, vision, and hearing care including cleanings, dentures, eyeglasses, and hearing aids

  • Doctor’s visit (in-network vs. out-of-network coverage is dependant on the provider)

  • Inpatient and outpatient mental health services

  • Medical equipment such as walkers, shower chairs, etc.

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Other benefits are dependent on the plan and provider you choose. These benefits may include:

 

  • Occupational and physical therapy

  • Speech and language pathology

  • Fitness, including exercise classes

  • Housekeeping

  • Caregiver counseling

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Eligibility

Eligibility

You can generally join one of these Medicare Advantage Plans:

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If all of these apply:

  • You live in the service area of the plan you want to join. The plan can give you more information about its service area. If you live in another state for part of the year, ask if the plan will cover you there.

  • You have Medicare Part A and Part B.

  • You're a U.S. citizen or lawfully present in the U.S.

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Cost

Cost

Part C Cost

Medicare Advantage, or Medicare Part C, is an alternative coverage option to Original Medicare that provides additional coverage options. Its cost is largely dependent on the provider you choose. 
 

Factors you can consider to estimate costs are:
 

  • The Plan’s Monthly Premium

  • The Plan’s Yearly Deductible

  • The Plan’s Copayments/Coinsurance

  • The Plan’s Limit on Out-of-Pocket Costs

Apply

Apply

Applying for Medicare does not have to be a difficult process. If you have been receiving disability benefits for two years or more regardless of age, you will automatically receive Medicare coverage. You are also automatically eligible if you are suffering from End-Stage Renal Disease (ESRD) or receive Railroad Retirement Board (RRB) benefits.

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You can begin the Part A and B application process three months before you turn 65. If you apply 3 months after your 65th birthday, you may receive lifetime late fees. For these reasons, we recommend applying as soon as possible in order to avoid coverage gaps and additional costs.

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This late penalty will also apply if you delay your application to Medigap and/or Part D prescription drug coverage. You may also apply for Medicare Advantage during any open enrollment period without additional fees.

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