Editing Medicare (United States) (section)

===Part C: Medicare Advantage plans===
{{main|Medicare Advantage}}
{{More citations needed|section|date=September 2019}}

Public Part C Medicare Advantage and other Part C health plans are required to offer coverage that meets or exceeds the standards set by Original Medicare but they do not have to cover every benefit in the same way (the plan must be actuarially equivalent to Original Medicare benefits). After approval by the Centers for Medicare and Medicaid Services, if a Part C plan chooses to cover less than Original Medicare for some benefits, such as Skilled Nursing Facility care, the savings may be passed along to consumers by offering even lower co-payments for doctor visits (or any other plus or minus aggregation approved by CMS).<ref>{{cite web |title=What is Medicare Part C? |url=https://www.hhs.gov/answers/medicare-and-medicaid/what-is-medicare-part-c/index.html |website=hhs.gov|date=June 7, 2015 }}</ref>

Public Part C Medicare Advantage health plan members typically also pay a monthly premium in addition to the Medicare Part B premium to cover items not covered by Original Medicare (Parts A & B), such as the [[Out-of-pocket expense|out-of-pocket]] (OOP) limit, self-administered prescription drugs, dental care, vision care, annual physicals, coverage outside the United States, and even gym or health club memberships as well as—and probably most importantly—reduce the 20% co-pays and high deductibles associated with Original Medicare.<ref>{{cite journal |last1=Pope |first1=Christopher |year=2016 |title=Supplemental Benefits Under Medicare Advantage |url=https://www.healthaffairs.org/do/10.1377/forefront.20160121.052787 |journal=Health Affairs |doi=10.1377/forefront.20160121.052787 |access-date=January 25, 2016}}</ref> But in some situations the benefits are more limited (but they can never be more limited than Original Medicare and must always include an OOP limit) and there is no premium. The OOP limit can be as low as $1500 and as high as but no higher than $9350 (as with all insurance, the lower the limit, the higher the premium).{{Citation needed|date=March 2025}} In some cases, the sponsor even rebates part or all of the Part B premium, though these types of Part C plans are becoming rare.{{Citation needed|date=March 2025}}

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