--- title: Medicare Advantage Plans Explained | Everything Senior Insurance url: https://eseniorinsurance-redesign-demo.pages.dev/medicare-advantage/ updated: 2026-10-09 --- Part C # Medicare Advantage plans, explained. A Medicare Advantage plan is a private plan that replaces Original Medicare for your hospital and medical coverage, and usually adds drug coverage and extras. The tradeoff is a network. Here is how to weigh it. [Compare plans with an agent](tel:+18012555340)[Is it right for me?](#is-it-right) AEP: OCT 15 TO DEC 7 CHANGES START JAN 1 Before you pick a plan Checklist Four things to check first. Your doctors **In network?** Your prescriptions **On the formulary?** Your costs **Copays + yearly limit** Your extras **Dental, vision, hearing** We check all four for you, at no cost. **AEP opens Oct 15**Coverage for 2027 starts January 1. Written by the Everything Senior Insurance Data Desk, reviewed by Christian Brindle. Last updated October 9, 2026 **Talk it through**A licensed agent can compare the plans we represent against your doctors and prescriptions, at no cost to you.[Call 801-255-5340](tel:+18012555340) **Medicare Advantage (Part C) is an all-in-one alternative to Original Medicare sold by private insurance companies approved by Medicare.** You still have Medicare and still pay your Part B premium, but the plan pays your claims. Most plans include Part D drug coverage, many have a $0 plan premium, and every plan caps what you pay in network each year. In exchange you usually use the plan’s network of doctors and hospitals. ## How Medicare Advantage works When you join a Medicare Advantage plan, Medicare pays the plan a set amount each month to cover your care. The plan then sets its own copays, coinsurance and network, within Medicare’s rules. It must cover everything Original Medicare covers, except hospice, which Original Medicare still pays. - **HMO plans** generally require you to use network providers and get referrals to see specialists. - **PPO plans** let you see out-of-network providers, usually at a higher cost. - **Special Needs Plans (SNPs)** are built for people with Medicaid, certain chronic conditions, or who live in a facility. ## What it costs You keep paying the Part B premium, $202.90 a month for most people in 2026. On top of that, the plan may have its own premium (many are $0), plus copays when you use care. Here’s the thing: a $0 premium is not the same as $0 cost. The number to look at is the plan’s yearly in-network out-of-pocket limit. Once you reach it, the plan pays 100% of covered care for the rest of the year. Every plan has one, and it is listed in the plan’s Summary of Benefits. Source: [CMS, 2026 Medicare Parts A and B premiums and deductibles](https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles) ## Is Medicare Advantage right for me? ### It can fit well if - Your doctors are in the plan’s network. - You want one card for medical and drug coverage. - You value extras like dental, vision or hearing. - A lower monthly premium matters more than predictable copays. ### Think twice if - You travel or split the year between states. - You want to see any doctor who takes Medicare. - You expect frequent specialist care or hospital stays. - You may want a Medigap plan later (health questions can apply after your first window). ## If your plan is ending in 2027 Plan terminations and service area reductions are larger than usual this year. Christian broke down industry estimates in August 2026 of roughly 1.8 million people whose Medicare Advantage plan may not continue, and that number is an estimate, not a final count. If your plan is ending you will get a letter from the plan, and you will have a Special Enrollment Period to choose new coverage. You do not have to take the first plan someone calls you about. Compare your doctors and drugs first. Source: [Christian Brindle and Glen Shelton, August 14, 2026 episode](https://www.youtube.com/watch?v=8daA-jwWCl0). ## When you can join or switch | Window | Dates | What you can do | |---| | Annual Enrollment Period | October 15 to December 7 | Join, switch or drop a Medicare Advantage plan for January 1 | | Medicare Advantage Open Enrollment | January 1 to March 31 | Switch Medicare Advantage plans once, or return to Original Medicare | | Initial Enrollment Period | 7 months around your 65th birthday | Join a plan for the first time | | Special Enrollment Periods | After a qualifying event | Move, lose other coverage, or your plan ends | More detail is in our guide to [Medicare enrollment periods](https://eseniorinsurance-redesign-demo.pages.dev/medicare-enrollment-periods/). ## How we help you compare An agent lists your doctors and prescriptions, then checks them against the Medicare Advantage plans we represent in your county. You see the premiums, copays and yearly limits side by side, and we explain the tradeoffs in plain language. There is no cost to you for this help. Good questions ## Questions, answered. **Is Medicare Advantage the same as Medicare?** No. It is a way to get your Medicare benefits through a private plan approved by Medicare. You still have Medicare, and you still pay the Part B premium. **Do Medicare Advantage plans include drug coverage?** Most do. A plan that includes Part D is called an MA-PD. If you join a Medicare Advantage plan without drug coverage, you generally cannot add a separate Part D plan. **Can I switch from Medicare Advantage back to Original Medicare?** Yes, during the Annual Enrollment Period (October 15 to December 7) or the Medicare Advantage Open Enrollment Period (January 1 to March 31). If you want a Medigap plan, the insurer may ask health questions outside your guaranteed issue windows. **What happens if my Medicare Advantage plan is ending?** The plan sends you a notice, and you get a Special Enrollment Period to choose new coverage. If you do nothing, you return to Original Medicare. Call us and we will compare the plans available in your county. **Does a $0 premium plan mean I pay nothing?** No. You still pay the Part B premium and any copays or coinsurance when you use care, up to the plan’s yearly in-network out-of-pocket limit. Let’s take the next step together ## Not sure your plan still fits? AEP runs October 15 to December 7. Call 801-255-5340 for a free plan review. [Call an advisor](tel:+18012555340)[Send a message](https://eseniorinsurance-redesign-demo.pages.dev/contact-us/)