Medicare Advantage · Part C
Medicare Advantage, explained simply.
A Medicare Advantage plan is an alternative way to get your Medicare coverage — one plan from a private insurer, instead of Original Medicare plus separate add-ons.
What is a Medicare Advantage plan?
Medicare Advantage plans, also called Part C, are offered by private insurance companies that Medicare approves. When you join one, the plan provides your Part A (hospital) and Part B (medical) coverage. Most Advantage plans also include Part D prescription drug coverage, so your hospital, medical, and drug coverage can all sit in a single plan.
You still have Medicare — you must be enrolled in Parts A and B to join an Advantage plan, and you continue to pay your Part B premium. The plan then administers your benefits under Medicare's rules.
How Advantage differs from Original Medicare
| Original Medicare | Medicare Advantage | |
|---|---|---|
| Who provides coverage | The federal government | A private insurer approved by Medicare |
| Drug coverage | Separate Part D plan needed | Usually included in the plan |
| Doctors and hospitals | Generally any provider that accepts Medicare | A plan network; rules vary by plan type |
| Out-of-pocket costs | No yearly cap on what you pay | Plans have a yearly limit on out-of-pocket costs |
| Extra benefits | Not included | Many plans include additional benefits beyond Original Medicare |
What to compare before you choose
- Your doctors and hospitals. Are the providers you use in the plan's network? Network rules are one of the biggest differences between Advantage plans.
- Your prescriptions. Are your drugs covered, and what would you pay? Check the plan's drug list (formulary) before you enroll.
- Your total costs. Look beyond the monthly premium — consider copayments, deductibles, and the yearly out-of-pocket limit together.
- How you get care. Some plans require referrals or prior authorization for certain services. Make sure the way the plan works fits how you like to get care.
- Extra benefits. Many Advantage plans offer additional benefits that Original Medicare does not. What is included varies by plan, so ask for the specifics of any plan you are considering.
No plan is right for everyone. Advantage plans differ from one another in networks, costs, drug coverage, and extra benefits. What works well for a neighbor may not fit your doctors or prescriptions. We can walk through the options from the carriers we are appointed with and help you compare them in general terms — and we will tell you plainly when another path may suit you better.
Common questions
Can I have a Medicare Supplement plan and a Medicare Advantage plan at the same time?
No. A Supplement plan works with Original Medicare only. If you join a Medicare Advantage plan, you cannot use a Supplement plan with it. This is an either-or choice, and it is worth understanding before you enroll.
Can I switch back to Original Medicare?
Usually, yes — during the Annual Enrollment Period each fall (October 15 to December 7), and in certain other situations. If you return to Original Medicare after having an Advantage plan, your ability to buy a Supplement plan may depend on your health and your state's rules, so ask about that before you switch. See our Enrollment Periods page.
Do Advantage plans cover me when I travel?
Coverage while traveling depends on the plan. Emergency and urgent care are generally covered anywhere in the United States, but routine care outside your plan's service area may not be. If travel matters to you, it is one of the things to compare. Call us and we can go over how different plan types handle it.
Want to compare Advantage options?
Bring your list of doctors and prescriptions, and we will walk through the choices with you.