Medicare Advantage

Medicare Advantage: everything in one plan.

Medicare Advantage plans combine your hospital and medical coverage — and usually your prescriptions — in one plan from a private company approved by Medicare.

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Key takeaways

You must have Parts A and B, and you keep paying your Part B premium.
Most plans use a network of doctors — check that yours are included.
Every plan has a yearly limit on out-of-pocket costs for covered medical services.

How it works

When you join a Medicare Advantage plan (also called Part C), you still have Medicare — but the private plan, rather than Original Medicare, handles your Part A and Part B coverage. Plans must cover everything Original Medicare covers, and most include Part D drug coverage. Many also offer benefits Original Medicare doesn't, like routine dental, vision and hearing care.

What you might pay

Your Part B premium ($202.90/month in 2026, unless you get help paying it)
A monthly plan premium — many plans have a $0 premium
Copays or coinsurance when you see the doctor, fill prescriptions or go to the hospital

A built-in safety net

Every Medicare Advantage plan has a yearly maximum out-of-pocket limit for covered hospital and medical services. Once you reach it, the plan pays for covered services for the rest of the year.

Networks: the most important thing to check

Most Medicare Advantage plans are HMOs or PPOs:

HMO

You generally use doctors and hospitals in the plan's network and may need a referral to see a specialist. Emergency and urgent care are always covered.

PPO

You can see doctors outside the network, but you'll usually pay more. Referrals are generally not needed.

There are also Special Needs Plans for people who have both Medicare and Medicaid, certain chronic conditions such as diabetes or heart failure, or who live in a nursing home.

Three older friends talking and smiling together — Extra benefits like fitness programs vary by plan and location.

Extra benefits many plans offer

Dental cleanings and exams, sometimes more
Eye exams and an allowance for glasses
Hearing exams and hearing aids
Fitness memberships
Allowances for over-the-counter health items
Rides to medical appointments

Benefits, limits and eligibility vary by plan and county, and can change each year.

Questions to ask before choosing

Are my doctors and my hospital in the network?
Are all my medicines covered — and what will they cost?
What's the yearly out-of-pocket maximum?
Will I need referrals or prior approval for care?
What happens when I travel to see family?

Our agents will go through each of these with you. Request a call →

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A friendly, licensed agent will explain your Medicare options slowly and clearly — and answer every question, however small. There's no cost for our help and no obligation.

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