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Medicare Advantage (Part C) plans are an alternative to Original Medicare offered by private insurance companies approved by Medicare.
Medicare Advantage plans bundle your Original Medicare benefits (Part A hospital insurance and Part B medical insurance) into one convenient plan. These plans are required to cover everything Original Medicare covers, but many include additional benefits like prescription drug coverage, dental, vision, and hearing services.
When you enroll in a Medicare Advantage plan, you're still in Medicare - you just get your benefits through the private plan instead. You'll still have Medicare rights and protections, but you'll receive your care from the plan's network of providers.
Most Medicare Advantage plans include Medicare drug coverage (Part D). If you join a Medicare Advantage Plan that includes drug coverage, you don't need a separate Part D plan.
Most plans include Part D drug coverage
Routine exams, cleanings, and often more
Eye exams, glasses, and contacts
Hearing exams and hearing aids
Gym memberships and fitness programs
Understanding the different plan types helps you choose the right coverage for your needs and budget
Health Maintenance Organization plans require you to use doctors in the plan's network, except in emergencies.
Preferred Provider Organization plans offer more flexibility to see any doctor, in or out of network.
Private Fee-for-Service plans determine how much they and you pay for services.
Special Needs Plans provide focused healthcare for people with specific diseases or characteristics.
Get answers to common questions about Medicare Advantage plans
Medicare Advantage costs include your monthly premium (often $0-$50), annual deductible, copayments for doctor visits and services, and out-of-pocket maximum limits. Many plans have $0 premiums but higher out-of-pocket costs. Compare plans in your ZIP code to find the best total cost for your situation.
Yes, you can switch during the Annual Election Period (October 15 - December 7) or during your Initial Enrollment Period when you first become eligible for Medicare. You can also switch during the Medicare Advantage Open Enrollment Period (January 1 - March 31) if you're already in a Medicare Advantage plan. Get free quotes to compare plans available in your area.
Most Medicare Advantage plans have provider networks. HMO plans generally require you to use in-network providers except in emergencies. PPO plans let you see out-of-network providers but at higher costs. Some plans like PFFS don't have networks but require providers to accept the plan's terms. Check if your doctors are in-network before enrolling.
Medicare Advantage plans have annual out-of-pocket maximums that limit how much you pay for covered services. For 2026, the maximum out-of-pocket limit cannot exceed $8,850 for in-network services (some plans have lower limits). Once you reach this amount, the plan pays 100% of covered services for the rest of the year. Original Medicare doesn't have this protection.
Most Medicare Advantage plans include Medicare Part D prescription drug coverage. These plans are called MAPD plans. If you want drug coverage through Medicare Advantage, make sure the plan you choose includes it - not all plans do. Compare plans to find one that covers your specific medications at the lowest cost.
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