Medicare Advantage Plans Explained

A Medicare Advantage Plan, also called Part C, is a Medicare-approved plan from a private insurance company. It provides your Part A and Part B benefits in place of Original Medicare, and most plans also include Part D drug coverage.

How Medicare Advantage works

• You keep paying your Part B premium ($202.90 a month for most people in 2026), plus any plan premium.
• You use the plan's card instead of your red, white and blue Medicare card.
• Each plan has a yearly limit on what you pay out of pocket for Part A and Part B services. Once you reach it, the plan pays 100% of covered services for the rest of the year.
• Many plans offer some extra benefits Original Medicare does not cover, such as routine dental, vision or hearing. Benefits vary by plan.

Common plan types

• HMO: you generally use the plan's network and choose a primary care doctor; referrals are often needed for specialists.
• PPO: you pay less in network and can go out of network for a higher cost; referrals usually are not needed.
• PFFS: the plan sets what it pays providers, and providers decide whether to accept the plan's terms.
• Special Needs Plans (SNP): for people with certain chronic conditions, people living in institutions, or people with both Medicare and Medicaid.

Read the full breakdown on our Medicare Advantage Plans page.

Who can join

You must have Medicare Part A and Part B and live in the plan's service area. Plans cannot deny you because of a pre-existing condition.

When you can join or switch

You can join when you first get Medicare, during Fall Open Enrollment (October 15 to December 7), and switch plans during the Medicare Advantage Open Enrollment Period (January 1 to March 31). See all Medicare enrollment periods.

Things to weigh

Medicare Advantage can make sense for people who want one plan with drug coverage and extra benefits. The trade-offs are networks, prior authorization rules and copays when you get care. Compare it side by side with Medigap using our guide on how to compare Medicare plans.

Frequently asked questions

What is a Medicare Advantage plan?

A Medicare Advantage Plan, or Part C, is a Medicare-approved plan from a private insurer that provides your Part A and Part B benefits and usually includes drug coverage.

Do I still pay my Part B premium with Medicare Advantage?

Yes. You keep paying your Part B premium, which is $202.90 a month for most people in 2026, plus any premium the plan charges.

Can I see any doctor with Medicare Advantage?

It depends on the plan. HMO plans generally require you to use network doctors, while PPO plans let you go out of network for a higher cost.

Is there a limit on what I pay in a Medicare Advantage plan?

Yes. Every Medicare Advantage Plan has a yearly out-of-pocket limit for covered Part A and Part B services. The limit varies by plan.

Talk with a licensed agent

Questions about your Medicare options? Call 1-844-438-6284 (TTY 711) or request a free, no-obligation quote. We do not offer every plan available in your area.

Sources for 2026 figures: CMS 2026 Medicare Parts A & B Premiums and Deductibles; Medicare.gov: Medicare costs; Medicare.gov: Part D costs. For information on all of your options, contact Medicare.gov or 1-800-MEDICARE (TTY 1-877-486-2048).