Medicare Advantage Plans—also known as Medicare Part C—offer an alternative way to receive Medicare benefits. These privately run plans often include added features like prescription drug coverage, vision, dental, and hearing care. For many Americans, they provide a more comprehensive or cost-effective solution compared to Original Medicare.
Medicare Advantage Plans—also known as Medicare Part C—offer an alternative way to receive Medicare benefits. These privately run plans often include added features like prescription drug coverage, vision, dental, and hearing care.
For many Americans, they provide a more comprehensive or cost-effective solution compared to Original Medicare.
This guide explains how Medicare Advantage Plans work, what they cover, how to compare options, and what to consider when enrolling.
What Is a Medicare Advantage Plan?
Medicare Advantage Plans are offered by private insurance companies approved by Medicare. When you enroll in a Part C plan, you still receive Medicare Part A (hospital) and Part B (medical) coverage, but through the insurer's network.
Many plans bundle additional benefits, such as:
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Prescription drug coverage (Part D)
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Routine dental cleanings and exams
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Eye exams and glasses
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Hearing exams and hearing aids
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Fitness programs like SilverSneakers
Plans must follow Medicare rules but can set their own out-of-pocket costs, provider networks, and referral requirements.
Types of Medicare Advantage Plans
Most people enroll in one of the following:
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HMO (Health Maintenance Organization): Requires you to use in-network providers and get referrals for specialists
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PPO (Preferred Provider Organization): Offers more flexibility in choosing doctors and doesn’t always require referrals
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SNP (Special Needs Plans): Tailored to individuals with chronic conditions, dual eligibility (Medicare and Medicaid), or institutional care needs
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PFFS (Private Fee-for-Service): Allows more freedom, but not all providers accept the terms
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MSA (Medical Savings Account): Combines a high-deductible plan with a savings account you can use for medical expenses
How Much Do Medicare Advantage Plans Cost?
Costs vary widely by plan and location. Common charges include:
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Monthly premium: Many plans have a $0 premium, but some charge an additional amount on top of your Part B premium
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Deductibles: Some plans have annual deductibles for medical services or drugs
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Copays and coinsurance: Fixed costs for doctor visits, hospital stays, or prescriptions
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Out-of-pocket maximum: Protects you from high annual expenses—plans cannot exceed $8,850 (in 2025)
Compare plans side by side to understand differences in total yearly costs, not just premiums.
How to Compare Medicare Advantage Plans
Use these criteria when reviewing plans:
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Network of doctors and hospitals
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Drug formulary (list of covered medications)
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Out-of-pocket limits
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Coverage for dental, vision, and hearing
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Telehealth availability
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Customer service ratings
You can use the official Medicare Plan Finder tool or search local insurance websites using terms like:
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“Compare Medicare Advantage Plans in my ZIP code”
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“Low-cost Medicare Part C options near me”
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“Best Medicare Advantage Plan for prescriptions”
When Can You Enroll?
You can join, switch, or drop a Medicare Advantage Plan during these periods:
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Initial Enrollment Period (IEP): Around your 65th birthday
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Annual Enrollment Period (AEP): October 15 – December 7 each year
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Medicare Advantage Open Enrollment: January 1 – March 31 (switch Advantage plans or return to Original Medicare)
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Special Enrollment Periods: If you move, lose coverage, or qualify for extra help
What to Consider Before Enrolling
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Are your current doctors in-network?
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Does the plan cover all your medications affordably?
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Are dental, vision, or hearing benefits important to you?
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What is the total cost of care, including copays and deductibles?
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Is the plan rated well by other members?
Reading the fine print on prior authorization rules, specialist access, and travel coverage is also important.
Final Thoughts
Medicare Advantage Plans can be a smart alternative to Original Medicare for people seeking bundled benefits and cost predictability. With hundreds of plans available in many areas, comparing options carefully can lead to better care and lower out-of-pocket costs.
Start by checking which plans are available in your ZIP code, reviewing provider networks, and comparing premiums and coverage details. A well-matched plan can simplify your health care—and your budget.