Medicare Advantage Plans
Part C, in plain English
Medicare Advantage — what it actually is.
How Medicare Advantage (Part C) works, what extras it bundles, and the trade-offs you should weigh before switching.
What Medicare Advantage is
Medicare Advantage plans are sold by private insurers and approved by Medicare. They replace Original Medicare (Parts A and B) for the time you are enrolled, and usually bundle in Part D prescription drug coverage. Most add extras like dental, vision, hearing, fitness, and transportation.
What to weigh
- Network rules. HMOs usually require you to stay in network. PPOs allow out-of-network at higher cost.
- Prior authorization. Some services may need approval before you receive them.
- Extras. Dental, vision, hearing, OTC allowance — these vary by plan and ZIP.
- Out-of-pocket maximum. Medicare Advantage caps your in-network out-of-pocket spending each year.
- Drug formulary. Confirm your drugs are covered and at what tier.