Medicare Part C in Pennsylvania
Medicare Part C plans in Pennsylvania are also known as Medicare Advantage plans. Medicare Part C is offered by private insurance companies. While these plans are offered privately, it is important to note that they include the same benefits as Original Medicare (Parts A and B). However, Part C plans offer additional types of coverage that are not otherwise covered by Original Medicare plans. As such, many people choose to enroll in Medicare Part C coverage in order to have a more comprehensive insurance policy. Companies that offer Medicare Plan C benefits receive set payments from the Medicare program to cover costs. Part C providers are required to follow Medicare rules, but they can also set additional rules when necessary. People who receive Part C Medicare coverage may find that their insurance provider requires them to visit certain hospitals, use specific doctors and obtain referrals before receiving some types of treatment. Learn what plans for Medicare Part C cover, how to enroll and what these programs cost in the outlined material below.
Types of Medicare Part C Plans in Pennsylvania
Part C Medicare in Pennsylvania is available in a few different formats. The Medicare Part C cost will vary based on which type of plan you choose as well as the company that offers it. If you want additional Medicare coverage, then you may be able to apply for one of the following plan types:
- Health Maintenance Organization
- Preferred Provider Organization
- HMO Point-of-Service
- Private Fee-for-Service
- Medical Savings Account
- Special Needs Plan
You may also be familiar with Medicare supplemental insurance in Pennsylvania, but it is important to note that this is not a type of Part C coverage. Supplemental Medicare insurance, more commonly referred to as Medigap, is also sold by private insurance companies. However, a Medigap plan is a separate type of coverage that provides different benefits. If you find that you do not meet the Medicare requirements for a Part C plan, then it is possible that you will qualify for a Medigap policy instead. While Medicare Part C in Pennsylvania has some similarities to Medigap, these policies cannot be combined to get coverage that is more comprehensive. Learn more about the difference between Part C plans and Medigap by downloading our health insurance guide.
Eligibility for a Medicare Part C Plan in Pennsylvania
To sign up for Part C Medicare in Pennsylvania, you need to meet a few eligibility criteria. First, you can only get a specific Medicare Part C plan if you live in the service area of the policy that you want. There are multiple plans available in Pennsylvania. When you do not live in the covered area for one plan, you may be able to find a similar option where you live. Second, Medicare Part C is only an option if you already have Parts A and B. As such, you must meet the criteria for getting Original Medicare. Once you sign up for Plan C Medicare, it will replace your Original Medicare policy. Third, you usually cannot obtain Medicare Advantage coverage if you have end-stage renal disease. When you have this condition, there are other options available. For example, you may be eligible for Medigap policies in certain situations.
How to Sign Up for Medicare Plan C in Pennsylvania
If you want a Medicare Part C plan in Pennsylvania, then there are only certain times of the year that you can obtain coverage or make changes to your plan. Plan C Medicare enrollment is open during the following times:
- Your Initial Enrollment Period, which is the time during which you first qualify for Medicare
- A Special Enrollment Period, which you are eligible for after certain life events and changes to your other insurance coverage
- Medicare Open Enrollment, which happens between October and December each year
- The Medicare Advantage Disenrollment Period, which happens January to mid-February every year
Since Medicare Part C plans in Pennsylvania are offered by private insurance companies, application methods will vary. If you want coverage for Part C Medicare in PA, then start by familiarizing yourself with your Medicare enrollment period options. Next, research Medicare Advantage plans and find out which companies offer policies in your area. You can apply for coverage by contacting private insurance providers directly.
What does Medicare Part C Cover in Pennsylvania?
In general, Medicare Plan C policies in Pennsylvania offer all of the same services that Original Medicare provides. Medicare Part C always provides urgent care and emergency medical services in addition to all of the benefits of Part A and B coverage. The reason that many people choose Medicare Advantage plans is that these policies offer additional services such as vision, dental, hearing and general wellness coverage. Note that these treatments are rarely covered by Original Medicare alone. Part C Medicare in Pennsylvania may also offer prescription drug coverage (Medicare Part D). However, not all plans offer this to beneficiaries and it may be necessary to purchase Part D separately. Learn more about what plans for Part C Medicare offer by reading our detailed health care guide.
Costs for Medicare Part C in Pennsylvania
The Medicare Part C cost in Pennsylvania can vary greatly depending on which company you choose. While all plans for Part C Medicare are required to cover the same types of service, companies are allowed to set their insurance prices. You can expect to pay a monthly premium as well as an annual deductible and copayments for each plan.