Medicare Advantage Plans, also called Part C, are health plan choices that are a part of Medicare. Generally, with these plans, all Medicare-covered health care is covered by the Medicare Advantage Plan. That can include prescription drug coverage too.
Medicare Advantage Plans include:
When you enroll in a Medicare Advantage Plan, you use the insurance card you receive from the plan for health care. Many of these plans offer extra benefits and lower copayments in comparison with the Original Medicare Plan. Most Medicare Advantage Plans are managed care plans – a health maintenance organization (HMO) or a preferred provider organization (PPO). If you enroll in a Medicare Advantage Plan, you might have to use only the healthcare providers outlined in your plan.
If you want to enroll in a Medicare Advantage Plan, you have to have Medicare Part A and Part B. That means you are going to have to pay your monthly Medicare Part B premium to Medicare. You might also need to pay a monthly premium to the Medicare Advantage Plan for additional benefits they provide. In 2020, the standard Part B premium is $144.60 (or more, based on your income). But people receiving Social Security benefits generally pay less than that, an average of $135 in 2019.
When can I enroll?
There are limits on when you can join, switch, or drop a Medicare Advantage Plan. You become eligible for Medicare Advantage Plan when you first become eligible for Medicare. That is from three months before the month you become 65 in, to three months after that month.
Part A premium
Most people don’t pay a monthly premium for Part A (sometimes called “premium-free Part A”). If you buy Part A, you’ll pay up to $458 each month in 2020. If you paid Medicare taxes for less than 30 quarters, the standard Part A premium is $458 in 2020. If you paid Medicare taxes for 30-39 quarters, the standard Part A premium is $252 in 2020.
Part A hospital and inpatient deductible
$1,408 deductible for each benefit period
Days 1-60: $0 coinsurance for each benefit period
Days 61-90: $352 coinsurance per day of each benefit period
Days 91 and beyond: $704 coinsurance per each “lifetime reserve day” after day 90 for each benefit period (up to 60 days over your lifetime)
Beyond lifetime reserve days: all costs
Part B premium
Most people pay $144.60 each month (or higher depending on your income). However, most people who get Social Security benefits will pay less than this amount.
Part B deductible and coinsurance
$198 per year. After your deductible is met, you typically pay 20% of the Medicare-approved amount for most doctor services (including most doctor services while you’re a hospital inpatient), outpatient therapy, and durable medical equipment.
Part C premium
Part C monthly premium varies by plan
Part D premium
The Part D monthly premium varies by plan (higher-income consumers may pay more)