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
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.
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.
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.