{"id":355792,"date":"2016-04-04T10:46:14","date_gmt":"2016-04-04T15:46:14","guid":{"rendered":"https:\/\/content.findlaw-admin.com\/ability-law\/healthcare\/medicare-medicaid\/medicare-managed-care.html"},"modified":"2025-09-09T08:27:00","modified_gmt":"2025-09-09T13:27:00","slug":"medicare-managed-care","status":"publish","type":"page","link":"https:\/\/www.findlaw.com\/healthcare\/medicare-medicaid\/medicare-managed-care.html","title":{"rendered":"Medicare Advantage Managed Care (Part C)"},"content":{"rendered":"\n
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Medicare Advantage Part C Coverage<\/h1>\n\n
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\n By Lyle Therese A. Hilotin-Lee, J.D.<\/a> | Legally reviewed by Jordan Walker, J.D.<\/a>\n | Last updated\n
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The last updated date refers to the last time this article was reviewed by FindLaw or one of our contributing authors<\/a>. We make every effort to keep our articles updated. For information regarding a specific legal issue affecting you, please contact an attorney in your area<\/a>.<\/em><\/p>\n\n <\/div>\n <\/details>\n<\/section>\n\n\n

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Medicare Advantage, also known as Part C, is a managed care option to original Medicare that bundles hospital, medical, and (usually) prescription drug coverage into one plan offered by private insurers approved by Medicare. These health insurance plans cover at least the same benefits as Parts A and B.\u00a0They often include extra health care services like dental, vision, and hearing as well, and can provide cost protection through an annual out-of-pocket limit.<\/i><\/p>\n\n <\/div>\n\n\n\n

If you have questions or concerns related to Medicare Part C or are dealing with unexpected issues related to your benefits, contact a\u00a0healthcare attorney<\/a>. They can help you understand your healthcare coverage and assist you in receiving the coverage you are entitled to under federal law.<\/p>\n

Understanding Medicare Part C<\/strong><\/h2>\n

Original Medicare (Part A and Part B) is run by the federal government.\u00a0Medicare Part C<\/a>, also known as Medicare Advantage, is a healthcare plan offered by private companies approved by the Medicare program. \u00a0The\u00a0companies with\u00a0these types of plan options\u00a0include\u00a0UnitedHealth, Aetna, Humana, and more.<\/p>\n

Most Part C companies use either a\u00a0Health Maintenance Organization (HMO)<\/a>\u00a0or\u00a0 a\u00a0Preferred Provider Organization (PPO)<\/a>\u00a0model\u00a0with provider networks. They deliver all the same hospital and medical care coverage as Original Medicare (Part A and B).<\/p>\n

Medicare Advantage may also offer extra coverage. Private insurance companies that operate Medicare Advantage plans create provider networks by contracting with hospitals, doctors, and other medical professionals. These networks are designed to provide coordinated care at negotiated rates.<\/p>\n

These plans can\u00a0include dental, hearing, vision, or a health and wellness program.\u00a0Medicare Advantage works\u00a0with certain networks of healthcare providers to provide coordinated care. These companies establish an agreement with hospitals, doctors, and other medical professionals. The agreements set negotiated rates for covered services provided to beneficiaries.<\/p>\n

Medicare Part C Eligibility<\/strong><\/h2>\n

Before you can enroll in Medicare Advantage (Part C), you must be able to qualify\u00a0for Original Medicare. This means\u00a0meeting the following criteria:<\/p>\n