Medicare Advantage Plans
May 20, 2026
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.
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What is Medicare Advantage in plain English?
A private alternative to Original Medicare. The plan provides your Part A and Part B benefits, usually a drug plan, and often extra benefits. You use the plan's network of doctors and hospitals.
How much does Medicare Advantage cost?
Premiums vary by plan; many are $0 in addition to your Part B premium. You still pay copays, coinsurance, and a deductible up to the plan's annual out-of-pocket maximum. Exact amounts vary by plan.
Do I still need Part B if I have Medicare Advantage?
Yes. You must stay enrolled in both Part A and Part B and continue paying the Part B premium while you have a Medicare Advantage plan.
What is the out-of-pocket maximum on Medicare Advantage?
Every Medicare Advantage plan must have an annual cap on what you pay for covered Part A and Part B services. The exact dollar limit varies by plan; once you hit it, the plan pays 100% of covered services for the rest of the calendar year.
When can I enroll in Medicare Advantage?
During your Initial Enrollment Period around your 65th birthday, the Annual Enrollment Period (October 15 to December 7), or the Medicare Advantage Open Enrollment Period (January 1 to March 31). Special Enrollment Periods apply if you move or lose coverage.
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.