Medicare Advantage (Part C)
A private health plan alternative to Original Medicare that bundles Part A, Part B, and usually Part D coverage.
What is Medicare Advantage?
Medicare Advantage (formally Medicare Part C) is an alternative way to receive Medicare benefits through private insurance companies approved by the Centers for Medicare and Medicaid Services (CMS). Enrollees receive at minimum the same coverage as Original Medicare (Parts A and B), and most Medicare Advantage plans also include Part D prescription drug coverage and additional benefits such as dental, vision, and hearing — which Original Medicare does not cover. Plans are offered as HMOs, PPOs, or other network-based models, requiring enrollees to use in-network providers for the lowest cost-sharing. Premiums vary but many plans charge $0 beyond the standard Part B premium. In exchange for lower premiums, Medicare Advantage plans impose network restrictions, prior authorization requirements, and out-of-pocket maximums that Original Medicare lacks. Enrollment has grown substantially — more than 50% of Medicare beneficiaries were enrolled in Medicare Advantage plans as of 2024.
Example
A 68-year-old retiree enrolls in a Medicare Advantage HMO plan with a $0 additional monthly premium, a $5,000 annual out-of-pocket maximum, and bundled dental and vision benefits. In contrast, Original Medicare has no out-of-pocket cap, no dental or vision coverage, and requires a separate Medigap policy to limit exposure — often at a higher total premium.
Source: CMS — Medicare Advantage