What Is Medicare Part C?

Medicare Part C also known as Medicare Advantage or a Medicare Advantage Plan, is an alternative way to receive your Medicare benefits. Instead of receiving coverage directly from the federal government through Original Medicare (Part A and Part B), you enroll in a private insurance plan that is approved by Medicare and administers your benefits. These plans are required to provide at least the same level of coverage as Original Medicare, and many include additional benefits.

How Medicare Advantage Works

• You must be enrolled in Medicare Part A (Hospital Insurance).
• You must be enrolled in Medicare Part B (Medical Insurance).
• You continue to pay your Part B premium and (Part A if required).

Medicare pays a private insurance company to manage your coverage. Once enrolled, your Medicare Advantage plan becomes your primary insurance. You present your plan ID card when receiving care and the private insurance company processes your claims. The plan sets its own copays, coinsurance, deductibles, and provider networks.

What Does Medicare Advantage Cover?
All Medicare Advantage plans must include hospital coverage (Part A services), doctor visits and outpatient care (Part B services), and emergency and urgent care.

• Prescription drug coverage (Part D) – often built into the plan.
• Dental benefits – exams, cleanings, and occasionally major services.
• Vision benefits – routine eye exams and eyewear allowances.
• Hearing benefits – hearing exams and hearing aid allowances.
• Other supplemental benefits depending on the carrier and service area.

Is a Medicare Advantage Plan the Right Choice for you?
For many individuals, Medicare Advantage can offer convenience, additional benefits, and an annual maximum out-of-pocket limit. However, it may be an excellent fit for some, and not the best solution for others. Every situation is different.

At Lighthouse, we sit down with you, review your doctors, prescriptions, and goals, and help determine which Medicare path makes the most sense for your specific needs.