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Medicare Advantage Plan (Part C)

Medicare Advantage Plan (Part C)

A type of Medicare health plan offered by a private company that contracts with Medicare. Medicare Advantage Plans provide all of Part A and Part B benefits, with a few exclusions, for example, certain aspects of clinical trials which are covered by Original Medicare even though a beneficiary is still in the plan.

A type of Medicare health plan offered by a private company that contracts with Medicare. Medicare Advantage Plans provide all of Part A and Part B benefits, with a few exclusions, for example, certain aspects of clinical trials which are covered by Original Medicare even though a beneficiary is still in the plan.

  • Medicare Medical Savings Account Plans
  • If a beneficiary is enrolled in a Medicare Advantage Plan:
  • Most Medicare services are covered through the plan
  • Most Medicare services aren’t paid for by Original Medicare
  • Most Medicare Advantage Plans offer prescription drug coverage
  • Medicare Advantage Plans, also known as Part C, are a type of Medicare plan that is offered by private insurance companies. These plans are designed to provide coverage for the services covered under Original Medicare (Parts A and B), as well as additional benefits such as vision, dental, and hearing coverage
  • One of the main benefits of Medicare Advantage Plans is that they can provide individuals with access to a wide range of medical services and benefits all in one place. These plans often have lower out-of-pocket costs than Original Medicare and may also include additional benefits such as routine vision, dental, and hearing coverage.
  • There are several different types of Medicare Advantage Plans, including Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), Private Fee-for-Service (PFFS) plans, and Special Needs Plans (SNPs). Each type of plan has its own unique features and benefits, and it is important to carefully consider all of the available options before enrolling.
  • It is important to note that Medicare Advantage Plans are required to provide at least the same level of coverage as Original Medicare, but they may have different rules and restrictions on coverage. In addition, individuals who enroll in a Medicare Advantage Plan may be required to use certain healthcare providers or facilities in order to receive coverage.

Understanding the limiting charge is essential for Medicare beneficiaries to avoid unexpected out-of-pocket costs when seeking care from providers who don't accept Medicare assignment.

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