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Understanding Medicare

The Medicare Plans (Yes, Plans)

What you need to know about Parts A, B, C and D

Medicare Part C — Your Private Insurance Option
Part C plans are offered through private insurance companies and approved by Medicare. They are also known as Medicare Advantage or Medicare Health plans.

Before enrolling in a Part C plan, you must first enroll in Original Medicare — both Part A and Part B. If you decide to use Medicare Advantage, you choose the plan yourself and sign up directly with the private insurer.

By law, Part C plans must pay for at least the same health care services as Original Medicare. But they sometimes pay for things that are not covered by Original Medicare, such as vision and dental care. Most, but not all, Medicare Advantage plans also provide some prescription drug coverage.

Medicare Advantage plans are generally organized as health maintenance organizations (HMOs) or preferred provider organizations (PPOs). Typically, in these types of plans you choose one doctor as your primary care provider, and your choice of doctors, hospitals and other health care providers is restricted. If you see providers outside of the plan’s network, you likely will pay more, or these providers’ care might not be covered at all.

Private fee-for-service Medicare Advantage plans, which allow for the regular use of out-of-network providers, are available in some areas.

You can check with Medicare for availability near you. For more detailed information, see the Medicare publication Your Guide to Medicare Private Fee-for-Service Plans.

Medicare Part D — Your Prescription Drug Plan
The newest addition to the Medicare alphabet, Part D, helps you pay for prescription drugs.

Part D is optional and available to people who are enrolled in Original Medicare (Parts A and B) and most Medicare Advantage plans.

Part D plans are offered by private insurance companies that are approved by Medicare. You sign up for them directly with the private insurer.

If you are enrolled in a Part D plan, you will pay a monthly premium and sometimes a deductible, as well as copayments for your drugs.

Each plan varies in the cost of premiums, the price of drugs and its list of covered drugs or "formulary" under the plan.

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