Comparing Medicare Part B to Medicare Part C
For those that might not think they need Medicare Part B, it might be that they have considered the options under Medicare Part C, which is also known as the Medicare Advantage Plan. The original Medicare Part A covers hospital and hospice stays, but doesn’t cover the additional services and treatments that are provided by Medicare Part B. Before you make the decision to not enroll in Medicare Part B or Medicare Part D, there are a few things to understand about Medicare Part C, which operates as like an HMO or PPO.
Medicare Part C combines Part A and Part B options and they must cover all medically needed services. For many people, the Part C coverage through these Medicare approved providers is offered at a lower cost, when compared to the original Medicare plans. Medicare Part C can offer additional benefits because some plans include a prescription drug program so it eliminates the need for the Medicare Part D coverage, which is the prescription drug portion of Medicare that costs additional premium, besides the Medicare Part B premium.
Under the HMO and PPO plans offered under the Medicare Part C plans, you will probably have to use doctors and hospitals in the network, but it helps to coordinate your care and get referrals into specialists. When you are traveling, you can still get emergency urgent care. Under Medicare Part B coverage you are free to choose from those that are approved by Medicare, which is not so restrictive.
Medicare Part C is offered through Medicare Preferred Provider Organization or PPO plans, Medicare Health Maintenance Organizations or HMO and Medicare Private Fee-For-Service or PFFS. These plans vary in cost and they vary by choice in hospitals and doctors.
Under the PPO plan, you will find it is much like the private insurance where you can choose the doctors and specialists you want, but if they aren’t in the PPO network, you might pay more. Under the HMO plan, you can only visit the doctors in the HMO network and you need a referral to see a specialist. Under the PFFS plan, you don’t need a referral to see a specialist and you can see any doctor or specialists, but they have to accept the fees that are Medicare approved. Under Medicare Part B, you don’t have these concerns, but there may still be costs that aren’t covered and you might need to consider Medigap or see if you qualify for Medicaid to help cover this gap in coverage.
The main things to consider when you are comparing Medicare Part B to Medicare Part C is what the premium differences are and whether you need to purchase the Medicare Part D, or prescription drug portion of the program. Before you can fully understand the differences in Medicare Part B or Medicare Part C, you need a full understanding of the insurance coverage provided under each plan you are considering. You can get information from a Medicare representative, if you are unsure what coverage you need, but in some cases, you are better taking Medicare Part B than Medicare Part C, but many times, it can also be the other way around, especially if prescription drug coverage is provided, as well.
Tags: medicare part c, medicare pat b