Medicare Part C

Medicare Advantage Plans

Medicare Part C, also known as Medicare Advantage plans, are Medicare-approved private health insurance plans for individuals enrolled in Original Medicare (Part A and Part B).

What does Medicare Part C (Medicare Advantage) cover?

Medicare Advantage covers all benefits under Medicare Part A and Medicare Part B, plus other options that can include:

• Vision services
• Hearing services
• Dental services
• Health and wellness programs
• Medicare Part D prescription drug coverage

How can I get Part C (Medicare Advantage)?

In most cases, you can join a Part C (Medicare Advantage) plan if you meet all these requirements:

• You're enrolled in Part A and Part B.
• You live in the plan's service area.
• You don't have end-stage renal disease (ESRD). Some exceptions may apply.
• You're applying when the plan is accepting new members, or you meet special circumstances.

Types of Medicare Part C plans

There are many options for Part C (Medicare Advantage) plans. We'll highlight the 2 main types that Kaiser Permanente offers. To find out which plans Kaiser Permanente offers in your area, see Medicare health plan descriptions. Or speak with a Kaiser Permanente Medicare specialist by calling toll free 1-855-223-3679 (TTY 711), 8 a.m. to 8 p.m., 7 days a week.

Medicare Advantage HMO plans

Medicare Advantage HMO plans use network providers for your care. By getting care in a coordinated network, you're more likely to have predictable copays and out-of-pocket expenses. If you go to a non-network provider, you may have to cover the costs, unless you're referred by a network provider, or if emergency or urgent care is needed.

Medicare Special Needs Plan (SNP)

If you have additional health care needs or a limited income, the Special Needs Plan is a Medicare Advantage plan that might be right for you. You may qualify for a Special Needs Plan if you:

• Live with a chronic or disabling condition
• Live in a nursing home or other institution
• Require an institutional level of care
• Qualify for both Medicare and state Medicaid (Medi-Cal in California).