Medicare Part C managed care plans are required to cover any medical service that would be covered under Medicare Part A and Part B. Also, many Medicare managed care plans add some coverage (though usually not much) that isn't covered by Part B. Each plan decides what extras it will offer (see "Do Medicare Part C plans offer broader coverage than Medicare Part A and Part B," below).
With Medicare Part C HMO plans, there are important restrictions on how you get your care:
- To get coverage from a Medicare Part C HMO plan, you can obtain care only from doctors, hospitals, and other healthcare providers who belong to the HMO's official "network" -- meaning providers who are under contract with the HMO.
- A Medicare Part C HMO plan won't pay for care by a specialist unless referred by your HMO-network primary care physician.
- Under a Medicare Part C HMO plan, you might not be covered for certain kinds of care unless the plan approves that care in advance.
- You have limited rights to appeal a decision made by the Medicare Part C plan with regard to the care they won't cover.
Two other types of Medicare Part C managed care plans, slightly different from HMOs, are available in some places. One is an HMO plan with a point-of-service (POS) option; the other is a preferred provider organization (PPO) plan. With either of these Medicare Part C plans, you can see a provider outside the plan's network, or see a specialist without first getting a referral -- but the plan will pay a smaller amount of the bill. These plans are less common than Medicare Part C HMOs and might not be available where you live.
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i need some help financially and some knowledge on taking care of my father who i 98 years old and has alzhemeirs and is now wearing depends he doesn't know how to use the bath room /toliet anymore i really need someone to help me with this situation and i will not put him in a home but i still do ned some time to myself and still take care of him too.
Yes, again another helpful article. I learned the difference between A, B, C plans for Medicare. Thank you
this website helped me very much. thanks
Please send me amount of medicare c.
Helpful but I wish you had discussed who PAYS FOR medicare advantage plans. And also discuss whether they are worth the amount of taxpayer money that goes to private insurance companies rather than medicare itself or medicare providers.
MEDICARE SHOULD COVER ACTOPUNCHERS, REALLY HELP PEOPLE ,AND SAVE MONEY
It will take me several reads to get through all this info, but it's very helpful in sorting out fact from the fiction pushed at us by health insurance companies.