Medicare Part C Definition | OnlineHealthIns.com Glossary

Medicare Part C (Medicare Advantage)

Also known as: Medicare Advantage, MA Plan

An alternative way to get Medicare benefits through a private insurance company, often bundling Part A, Part B, and usually Part D, plus extra benefits.

Medicare Part C, better known as Medicare Advantage, lets beneficiaries get their Medicare benefits through a private insurance company instead of directly through the government. These plans must cover everything Original Medicare (Part A and Part B) covers, and most also bundle in Part D prescription drug coverage.

Often structured as HMO or PPO plans, with defined provider networks.
Frequently include extra benefits not covered by Original Medicare, like dental, vision, or hearing.
May have different, sometimes lower, out-of-pocket cost structures than Original Medicare, but with network restrictions.

Medicare Advantage plans have their own annual out-of-pocket maximum, something Original Medicare alone doesn't have unless paired with a Medigap policy. In exchange for potential extra benefits and cost caps, members typically give up some flexibility and must generally use the plan's network.

A common misconception is that Medicare Advantage is a supplement added on top of Original Medicare. It actually replaces how you receive Part A and Part B benefits, run through a private plan instead of directly through the government, which is a meaningfully different structure than a Medigap policy.

Example

A retiree enrolls in a Medicare Advantage HMO plan that bundles hospital, medical, and drug coverage together, plus a routine dental benefit, in exchange for using the plan's provider network.

Good to Know

Medicare Advantage replaces how you receive Part A and B benefits; it's a different structure than adding a Medigap supplement to Original Medicare.

Related Terms

Medicare Part A — The part of Medicare that covers inpatient hospital stays, skilled nursing facility care, hospice, and some home health care.

Medicare Part B — The part of Medicare that covers outpatient care, doctor visits, preventive services, and medical equipment, and typically requires a monthly premium.

Medicare Part D — The part of Medicare that covers outpatient prescription drugs through private plans that contract with Medicare.

HMO (Health Maintenance Organization) — A health plan that covers care mainly through a network of contracted providers and usually requires you to pick a primary care physician and get referrals to see specialists.