What is Medicare Part C and will Coverage Affect Auto Insurance?

What Is Medicare Part C? Medicare Part C is more commonly referred to as Medicare Advantage and is one of your options when selecting a Medicare health plan. You may also recognize it as an “MA” plan. Medicare Part C is somewhat similar to a PPO or HMO. 

What is Medicare Part C? The plan is created and managed by Medicare-approved private companies, but conditions vary and you may need to consider where you reside to understand how Medicare Part C can impact car insurance.

What Does Medicare Plan C Cover?

The Medicare Advantage Plan will cover the same things that are covered by Medicare Plan A, which is hospital insurance, and everything included in Medicare Plan B, which is medical insurance. Medicare Part C is an alternative to Parts A and B. Hospital and medical insurance are crucial in the event of an auto accident.

Some MA plans may also include a variety of extra coverages such as dental for routine visits and cleanings, hearing, vision, and even programs for health and wellness such as discounted gym memberships. 

Many MA programs will also include Medicare coverage for prescription drugs, usually referred to as Part D and these can be essential in the aftermath of a car accident.

Some Medicare Part C plans may also offer extra benefits like transportation services to medical visits or over-the-counter pharmaceuticals. There are Plan C companies that may also tailor their insurance coverage or customize benefits for specific medical conditions for the chronically ill that are enrolled. 

It’s wise to research if you qualify for special customized coverage and if any limits exist.

Upon selecting a Medicare Advantage program, you will still be receiving Medicare, but things covered under parts A and B will be covered by Part C and no longer by the original Medicare program.

In essence, Part C is a “bundled” health insurance plan that combines the services covered in Parts A and B, and in most cases in Part D as well.

How does an MA Plan Work?

Private companies offering Medical Advantage Plans must be approved by Medicare and must follow all rules established by Medicare. Medicare will pay a company offering MA plans a specific monthly amount of money for your medical care.

What may differ with these plans is that individual companies are permitted to charge varying out-of-pocket costs or deductibles. They also are allowed to create their own set of rules when it comes to obtaining services. 

This may concern what doctor you go to if you require a specialist and potentially you may be required to visit facilities or see doctors that belong to the plan in the event of medical needs that are not urgent or an emergency. The rules for these services can change annually.

Are Medicare Part C Plans Costly?

How much a Medicare Part C may cost you will be influenced by several factors. The majority of plans will require you to use healthcare providers and medical professionals that belong to the MA network. 

Some MA plans will not pay for services that are provided by those outside of the plan’s service partners or those not belonging to the plan’s network, so you will pay if you choose care elsewhere.

While Part C plans do require some out-of-pocket expenses, they do have an annual limit for out-of-pocket costs for the services covered under traditional Medicare Parts A and B. If you reach the limit, you will not be expected to pay any more for other hospital or medical expenses traditionally covered in Parts A and B.

The Pros and Cons of Medicare Part C Plan

If you feel your Medicare coverage is not sufficient for your needs, you may want to consider a Part C plan as an alternative to traditional Medicare. Consider these pros and cons.

Medicare Part C Pros

• There may be more coverage offered than with traditional Medicare coverage including dental, vision, hearing, or wellness benefits.
• The majority of Part C plans include Part D for prescription drugs.
• Companies place an annual limit on out-of-pocket expenses.

Medicare Part C Cons

• The network of healthcare professionals may be smaller to choose from.
• Part C plans cannot be used together with healthcare supplement benefits to the original Medicare sponsored by employers.

Will Medicare Part C Affect My Auto Insurance?

As a Medicare recipient, health benefits can be used to pay for car accident injuries, but there are some potential conditions.

• Medicare, whether Part A, Part B, or Part C will always be a secondary provider and payer after your car insurance provider. This means that Medicare will not kick in until your car insurance policy’s limits have been exhausted. 
• Depending on the extent of the injuries, the auto insurance provider alone may pay. If injuries are extensive and require long-term care, it may be a combination of both the car insurance provider and Medicare.
• If you receive a settlement from the driver who has caused the accident or his or her insurance provider, Medicare will expect that you reimburse any payments made on your behalf. Medicare cannot claim reimbursement from settlements made for pain and suffering.

In theory, Medicare will cover injuries related to auto accidents if the driver does not have auto insurance providing coverage.

Auto Insurance Considerations

Types of auto insurance and where you reside can make a difference in how useful your Medicare Part C plan can be.  In states like New Hampshire or Maine, drivers are required to have MedPay Insurance so that all medical bills for the driver and passengers are automatically covered, meaning that a medicare Part C plan will not necessarily be helpful.

In no-fault states like Michigan, PIP (Personal Injury Protection) coverage is required, so there may be some savings to be had with a Medicare part C plan. Medicare coverage including Part C means that if you select to opt out of PIP (Personal Injury Protection) coverage, you will save 100% of the PIP cost. This can amount to significant savings. 

However, before deciding to opt out of PIP, consider your Medicare deductible, and any copayments you may be required to pay to evaluate how much you may save in the event of an accident.