Toni:
I attended your “Confused about Medicare” workshop last Thursday at Leisure Learning. I do not understand the difference between Original Medicare’s Plan C and Medicare’s Part C. Why are there 2 difference “C”s? Are there different plans and parts?
I am turning 65 on June 6, 2013 and am really confused. Can you explain these simple terms, so I can understand what is going on? Thanks, Jerry, a Cypress Creek Mirror reader.
Hi there, Jerry:
This is not as confusing as you might think. Medicare does have different Parts and Plans. I will make this as simple as I can….The different Parts involve Medicare and the different Plans have to do with Medicare Supplements also known as Medigap policies. I will explain them in detail below:
Original Medicare has 4 different Parts: A, B, C, & D
- Medicare Part A: (Hospital Insurance) covers inpatient hospital stays,
skilled nursing stay, hospice and home health
- Medicare Part B: (Medical Insurance) covers doctor services, outpatient care and surgery, durable medical equipment and preventative services.
- Medicare Part C: is also known as Medicare Advantage Plans
- Medicare Part D: Medicare prescription drug coverage which is administered by private insurance companies.
Let’s discuss the difference in the two types of Medicare options. Chapters 6 and 8 of my book Medicare Survival Guide or pages 57-71 of the 2013 Medicare & You handbook explains Medicare Supplement plans such as Plan C and a Medicare Advantage Plan or Part C. Some of the differences between a Medicare Supplement and a Medicare Advantage Plan are listed below:
1) Medicare Supplement: Plans A, B, C, D, F, G, K, L, M, N
- A Medicare Supplement works directly with “Original Medicare”. Medicare will pay its share of the Medicare-approved amount for Medicare covered healthcare costs. Then your Medicare supplement will pays its share.
- Freedom to chose which doctor, hospital, etc
- The premium may increase every year.
- Can enroll and will pay separately for a “Stand alone” Medicare (Part D) Prescription drug plan.
2) Medicare Advantage Plan: Part C
- To qualify: a)You must be enrolled in both Medicare Parts A & B…b)Live in the service area 6 months out of a year…c)Not have end stage renal disease (kidney dialysis)
- Medicare pays the Medicare Advantage insurance company a certain amount every month for your care as long as you are on the plan. Your Part B must always be in effect.
- You must only use your Medicare Advantage insurance card, not your Medicare red, white and blue card.
- Must provide all of your Part A and Part B benefits and some Medicare Advantage Plans have Part D prescription drug plans included.
- May have a zero to low dollar premiums with various co pays, deductibles and has maximum out of pocket to meet
- Many plans offer extra benefits such as gym memberships, dental benefits, transportation and other additional benefits.
- Many healthcare facilities, such as MD Anderson accept very few Medicare Advantage plans. Call your specific provider or facility and make sure they accept which Medicare Advantage plan you want to enroll in… (Very Important)
**** Toni’s Confused about Medicare workshops on Wednesday, May 15th, 2013 answers questions such as the difference in Plan C or Part C., donut hole, difference between “Original” Medicare, a Medicare supplement or Medicare Advantage Plan. These questions and many more will be answered at the Confused about Medicare Workshop to be held at The Abbey at Westminster Plaza, 2865 Westminster Plaza Dr., Houston, TX 77082 on Wednesday, May 15thth at 6:30 PM. The presentation is free of charge and open to the public. RSVP by calling 832/800-4674 as seating is limited.
Toni King is the author of Medicare Survival Guide is on sale at www.tonisays.com. Toni is an advocate/consultant for those “Confused about Medicare”. Email questions to toni@tonisays.com or call 832/519-TONI (8664).
