The amount you pay in deductibles and copays for Medicare Advantage will vary depending on the plan you choose and where you live. Get started How do factors such as deductibles and copay levels vary between Part C (Medicare Advantage) and Part D? For the 2023 coverage year, about 51% of the Medicare-eligible population opted for a Part C plan. Most Part C plans include Medicare Part D, but you can also purchase Part D separately if you have a Part C plan that does not include it. May be limited to a network of healthcare providers and hospitals Monthly premium, copayments, deductibles, coinsurance May include dental, vision, hearing, and fitness benefits Special enrollment period if you have a qualifying life eventĪnnual open enrollment (October 15 - December 7) Prescription medications, vaccines, and some medical suppliesĪnnual open enrollment (October 15 - December 7) Additional open enrollment period (January 1 - March 31) Hospital services, medical services, prescription medication, and more depending on the plan Stand-alone prescription medication coverage Replaces Original Medicare and becomes your hospital and medical insurance plan ![]() What do Medicare Part C and Part D have in common? This is when you can join a new Medicare Part D plan, change to a different plan, or drop your Part D coverage. The annual open enrollment happens each year from October 15 to December 7. But if you already have qualified prescription medication coverage through your job, spouse, or partner, the penalty will not apply as long as you sign up for Part D during your special enrollment period after your coverage ends. Like with Medicare Parts A and B, it's important to sign up for Part D as soon as you’re eligible to avoid paying a penalty. Live in the area where the Part D plan you want to enroll in is offered To join a Medicare Part D prescription plan, you must: Typically, medication in lower tiers have more affordable out-of-pocket costs, while medications in higher tiers may cost more. The medications on the formulary are organized into different tiers, and the cost for each medication depends on its tier. This formulary includes generic and brand-name prescription medications. Vaccines like shingles and Tdap (tetanus-diphtheria-pertussis)Įach Part D plan has its own list of covered medications called a formulary. Prescription medications you get at the pharmacy or through mail order Medicare Part D covers a wide range of prescription medications. Part D plans are offered by private insurance companies approved by Medicare. It helps people enrolled in Original Medicare (Part A and Part B) pay for prescription medications. Medicare Part D is prescription drug coverage. You may also be eligible for a special enrollment period if you experience certain life events. Medicare Part C plans also have an additional enrollment period between January 1 and March 31, when you can change Part C plans or return to Original Medicare. This period starts 3 months before your 65th birthday and lasts for 7 months.Īlternatively, you can change from Original Medicare to a Part C plan during the annual open enrollment period, from October 15 to December 7. You can enroll in a Medicare Part C plan when you first become eligible for Medicare, during your initial enrollment period. Live in the service area of the Part C plan you want to join To join a Medicare Part C plan, you must:īe enrolled in Medicare Part A and Part B Original Medicare allows you to see any provider who accepts Medicare. If you go out of network, your costs may be higher. With Medicare Part C, you usually receive your care from healthcare providers who are in-network with your plan. If your Part C plan is a private fee-for-service plan, it may or may not provide medication coverage. And if you have an HMO or PPO plan through Part C, you can’t purchase a stand-alone Part D plan. For example, health maintenance organization (HMO) and preferred provider organization (PPO) plans offered through Part C typically include prescription medication coverage. The type of Part C plan you choose will determine what’s covered. Medicare Part C plans may also offer extra benefits that Original Medicare does not, including coverage for: For example, each MA plan can charge different out-of-pocket costs. ![]() Medicare Part C plans must cover all the services that Original Medicare does. ![]() These companies have contracts with Medicare to provide all your Part A and Part B benefits. With Medicare Part C, you get your benefits through private health insurance companies. Part A covers hospital stays, and Part B covers visits with your healthcare providers and other outpatient care. With Original Medicare, you get Part A and Part B. Medicare Part C - or Medicare Advantage - is an alternative to Original Medicare.
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