Questions and Answers
What is Medicare Part C also referred to as?
What is Medicare Part C?
A managed care plan offered by Medicare-approved private insurers.
What may Part C be offered as?
A managed care plan offered by Medicare-approved private insurers.
What is a special needs plan?
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When can an individual enroll in Part C?
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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?
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What do Part C plans charge a combined premium for?
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As of 2012, what can't Part C plans do?
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Can a person stay enrolled in Part C if they develop ESRD after being enrolled?
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What must an individual have to enroll in Part C?
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Can someone be enrolled in Part C if they are insured under an employer health plan?
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Study Notes
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.
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Description
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.