Medicare Advantage (Part C)

Medicare Advantage is a Medicare-approved alternative to Original Medicare offered by private insurers. Plans must cover Part A and Part B services and often include extras. This is educational information only.

General information only — not a recommendation of any plan. Plan availability, costs, and benefits vary by county and eligibility.

What is Medicare Advantage?

Medicare Advantage (Part C) plans are offered by private companies that contract with Medicare. They must cover at least what Original Medicare covers for Part A and Part B. Many also include Part D prescription coverage and extra benefits such as dental, vision, hearing, or fitness — benefits and networks vary by plan and county.

What's typically included

• Part A (hospital) and Part B (medical) covered services
• Part D prescription coverage in many (not all) plans
• Possible extras such as dental, vision, hearing, fitness, transportation, or OTC allowances — plan-specific

Networks and plan types

Unlike Original Medicare's nationwide any-provider model (when providers accept Medicare), Advantage plans often use networks:

• HMO — Generally in-network care; referrals often needed
• PPO — More flexibility; higher cost-sharing out of network
• PFFS — Private fee-for-service; not all providers accept the plan
• MSA — High-deductible plan with a Medicare savings account
• SNP — Special Needs Plans for certain eligibility (see D-SNP and C-SNP pages)

Costs

You must continue paying your Medicare Part B premium while enrolled in Medicare Advantage. Some plans may have a $0 plan premium — that is not guaranteed and depends on the plan and year. You may also have deductibles, copays, coinsurance, and an annual out-of-pocket maximum set by the plan. Always confirm current costs in the official plan documents.

Enrollment periods

You generally need Part A and Part B and must live in the plan's service area. Common times to enroll or switch include your Initial Coverage Election Period (when you first get Medicare), the Annual Enrollment Period (October 15 – December 7), and Special Enrollment Periods if you qualify. (Do not confuse AEP with other open enrollment names.)

Comparing carefully

Medicare Advantage can work well for people who want extras and a single plan card — but networks, prior authorization, and drug formularies matter. Compare carefully with Medigap and stand-alone Part D. We can review options available through the carriers we represent; we do not offer every plan in your area.