The Medicare Part C Advantage
The Medicare Part C advantage comes in five ways. The Medicare Part C advantages are in relation, or even opposition, to Original Medicare. These are the advantages of Medicare Part C, though they will vary from plan and location.
The Medicare Part C Advantage is Maximum Out-Of-Pocket
The Medicare Part C advantage comes first in a maximum out-of-pocket. Original Medicare Part A has a $1,340 deductible per event in a 60-day period. There is no limit or maximum out-of-pocket on the Part A deductible. You could pay it once, twice, or even ten times in a year. Original Medicare Part B co-insurance is 20%. The twenty percent does not have a limit, cap, or maximum out-of-pocket. The sky is the limit. Twenty percent of a million dollars is real money! All Medicare Part C plans have a maximum out-of-pocket. They are currently set at a maximum of $6,700, but many plans are much lower than that.
Part D Included
The Medicare Part C advantage secondly is the inclusion of Medicare Part D. Instead of purchasing a separate stand-alone Medicare Part D plan for $30, $50, or $100, Medicare Part D coverage is usually included in the Part C plan. You do not have to purchase a separate Medicare Part D plan, and many of the Medicare Part C plans are zero premium or a very low premium. So your Part D is included for zero. Not purchasing a Part D plan could be a $400–$700 savings per year in premium costs.
The Medicare Part C advantage thirdly is minimal co-pays. An emergency room visit with Original Medicare Part B is a 20% co-insurance. When I broke my arm a few years ago, my emergency room visit was over $3,000. If I had been on just Original Medicare at the time, my bill would have been over $600. The co-pay for an emergency room visit on Medicare Part C plan is currently an $80 co-pay.
The Medicare Part C advantage fourthly is the monthly premium. Most Medicare Part C plans in the Omaha area are zero premium. There are a couple of plans that charge a very small premium, but it is minor when considered Medicare supplements or the usual deductibles and co-insurance with most employer group health plans. You continue to pay your Medicare Part B premium out of your Social Security, but there is no additional monthly premium.
Dental and Vision
The Medicare Part C advantage fifthly is some dental and vision insurance. People constantly ask me if Medicare covers dental. Original Medicare does not include any dental plans or prescription eye coverage. It does not cover teeth whitening, dentures, fillings, etc. A person would have to purchase a stand-alone dental insurance for seniors. Some of the Medicare Part C plans include Medicare dental coverage, such as teeth cleaning, eyeglass credit, reimbursement for fillings and extractions, etc.
Medicare Part C has clear advantages over just Original Medicare and a Part D prescription drug plan. The Medicare Part C / Medicare Advantage plan limits your out-of-pocket costs, saves money on Part D, keeps your co-insurance down, does not cost any more than Original Medicare in most cases, and potentially gives some additional benefits, like dental and vision. Medicare Advantage is much more advantageous than just Part A and Part B.