Medicare Advantage Plans
Also known as Medicare Part C, these plans bundle your Medicare Part A and Part B coverage with extra benefits.
What Is Medicare Advantage?
Medicare Advantage (Part C) is an alternative to Original Medicare. Instead of using Original Medicare (Part A and Part B) directly, you get your coverage through a private insurance company approved by Medicare.
These plans must follow Medicare rules and cover everything that Original Medicare covers, but they often include extra benefits that Original Medicare doesn't, such as vision, dental, hearing, and gym memberships.
Most people pay a monthly premium in addition to their Part B premium, and costs are typically capped so you know the most you'll pay out of pocket each year.
Key Facts
- Plan Type:Private plan (Part C)
- Monthly Premium:$0 - $50 (varies by plan)
- Deductible:$0 - $505 per year
- Out-of-Pocket Max:$3,700 - $7,550 per year
- Extra Benefits:Yes (vision, dental, hearing, gym)
Types of Medicare Advantage Plans
The most common types of Medicare Advantage plans are HMO, PPO, EPO, and PBM.
HMO Plans
Health Maintenance Organization plans typically have lower monthly premiums and deductibles. You usually need to stay within the plan's network and get referrals for specialists.
Best for: Those who want predictable costs and don't mind staying in-network.
PPO Plans
Preferred Provider Organization plans offer more flexibility to see doctors outside the network, usually for a higher cost. You typically don't need referrals for specialists.
Best for: Those who want flexibility to see any doctor, including out-of-network providers.
EPO Plans
Exclusive Provider Organization plans are like PPOs but don't cover any out-of-network care except in emergencies. They often have lower costs than PPOs.
Best for: Those who want PPO-like flexibility within a network at a lower cost.
PBM Plans
Private Fee-for-Service plans don't use networks. You can see any doctor or hospital that accepts Medicare, but costs may be higher.
Best for: Those who want to keep their current doctors without network restrictions.
Extra Benefits Included
Most Medicare Advantage plans include benefits that Original Medicare doesn't cover.
Vision
Routine eye exams, glasses, and contacts are often covered.
Dental
Routine cleanings, exams, and sometimes major procedures.
Hearing
Annual hearing exams and hearing aid coverage.
Medicare Advantage FAQs
Common questions about Medicare Advantage plans.
Yes, you can switch during your Initial Enrollment Period, Annual Enrollment Period (October 15 - December 7), or if you qualify for a Special Enrollment Period. You can also switch from one Medicare Advantage plan to another or back to Original Medicare.
Yes, you pay your Part B premium (and Part A if applicable) plus any premium required by your Medicare Advantage plan. Some Medicare Advantage plans have $0 premiums.
Most Medicare Advantage plans provide coverage for emergency care anywhere in the U.S. For routine care while traveling, check with your plan for coverage details. Some plans have nationwide networks.