Medicare Advantage Drug Coverage Part (C)

Medicare Part C is a combination of your Part A and Part B options and must cover all medically needed services.  One difference is that private insurance companies that are approved by Medicare provide this type of coverage.  Part C is a lower cost alternative to the Original Medicare Plan and provided usually offer extra benefits and include prescription drug coverage (Part D).  Part C plans often have networks, and you must use the doctors or hospitals that belong to the plan. 

Medicare Advantage had several plans available.  The Part C plans include the following:

• Medicare Health Maintenance Organizations (HMO): You would only be able to visit doctors in the HMO network. In most cases, you will be required to have a referral to visit a specialist.
• Medicare Preferred Provider Organization (PPO): You are able to see any doctor or specialist you prefer.  If the doctor or specialist isn’t in the PPO network, your cost will increase.  You usually don’t need a referral to see a specialist.
• Medicare Private Fee for Service (PFFS): You are able to se any doctor or specialist, but they must accept the PFFS’s fees, terms, and conditions. You usually don’t need a referral to see a specialist.
• Medicare Special Needs: These plans are designed for people with certain chronic diseases or other special health needs.  These plans must include Part A, Part B, Part C, and Part D coverage.