A question commonly asked by Washington residents who are new to Medicare is, “What’s the difference between Medicare Part C and Medicare Advantage?” and the answer is, there isn’t! Medicare Advantage and Medicare Part C are different names for the same type of Medicare insurance plans.
Medicare Advantage plans, aka Medicare Part C plans, are private plans run through Medicare that by law have to be at least “equivalent” to regular Part A and Part B coverage. That is, at the minimum, they must provide the same coverage as Original Medicare.
With Medicare Advantage (aka Part C), You Get More Options
Medicare Part C gives you more options for your Medicare coverage- there’s plenty of variation among Part C plans. For example, one plan may provide higher coverage for care received at a skilled nursing facility or in-home health care, while another may provide more coverage for frequent doctors visits or hospitalizations. Because of this variety, you are able to pick and choose the plan that has the best coverage for your specific medical needs.
Certain Medicare Advantage plans provide coverage much higher what is offered in Original Medicare Parts A and B, and some include extra benefits, such as discounts on gym memberships. Some -but not all- plans may even include prescription drug coverage, eliminating the need for a Medicare Part D plan.
Don’t Combine Medicare Advantage and Medigap
However, please note: if you have a Medicare Advantage plan, do not also enroll in a Medigap policy. The two cannot be combined, and Medigap won’t pay if you are covered by Medicare Part C.
Just as the coverage varies among Medicare Advantage plans, so does the monthly premium. Your monthly cost varies widely depending on which county in Washington you live in, the private insurer you choose to manage your plan, as well as whether you choose an HMO or PPO for your Medicare Advantage coverage.