Medicare Part C Flashcards

What is Medicare Part C also referred to as?

What is Medicare Part C?

What may Part C be offered as?

What is a special needs plan?

When can an individual enroll in Part C?

What must an individual do if they move out of the state or out of the plan's service area under a Part C Medicare plan?

What do Part C plans charge a combined premium for?

As of 2012, what can't Part C plans do?

Can a person stay enrolled in Part C if they develop ESRD after being enrolled?

What must an individual have to enroll in Part C?

Can someone be enrolled in Part C if they are insured under an employer health plan?

Medicare Part C Overview

Medicare Part C is also known as Medicare Advantage.
It is a managed care plan provided by private insurers approved by Medicare.

Plan Types

Special Needs Plans (SNP) are designed for individuals eligible for both Medicare and Medicaid.
Medicare Part C may accommodate those with employer health plans.

Enrollment Criteria

Eligibility for enrollment in Part C requires having Medicare Parts A and B, living within the plan's service area, and not having End-Stage Renal Disease (ESRD).
If someone is covered by an employer health plan, they may also enroll in Part C.

Enrollment Periods

Key periods for enrollment, changes, or dropping Part C include:
- Initial Enrollment Period
- Open Enrollment Period
- General Enrollment Period

Moving and Coverage Changes

A beneficiary must enroll in a new plan during the open enrollment period if they move out of their existing plan's service area.

Premiums and Costs

Part C plans charge a combined premium that typically covers both Medicare Parts A and B. Part D coverage may incur a separate charge if included.
As of 2012, Part C plans cannot charge beneficiaries more than Original Medicare for certain medical services, including chemotherapy, dialysis, and skilled nursing facility care.

ESRD and Enrollment

Individuals can maintain their enrollment in a Part C plan even if they develop ESRD after joining, as long as they did not have the condition at the time of enrollment.

Test your knowledge of Medicare Part C with these flashcards! This quiz covers the basics of Medicare Advantage, including definitions and offerings related to this program. Perfect for anyone looking to understand or review Medicare Part C concepts.