How Much Does Medicare Advantage (Part C) Cost? (2024)

Medicare Part C, or Medicare Advantage, is an alternative way to receive Medicare benefits. It bundles Medicare Part A (hospital insurance) with Medicare Part B (medical insurance) and often Medicare Part D (prescription drug coverage). Instead of receiving Part A and Part B benefits through Original Medicare, which is administered by the federal government, Part C beneficiaries receive coverage through a private health insurer approved by Medicare.

To be eligible for a Medicare Part C plan, beneficiaries must be enrolled in Medicare Part A and Part B and live within the plan’s specified service area. Individuals who meet these criteria can choose to get their coverage through a Medicare Part C plan instead of Original Medicare, explains Jeff Collins, a Medicare expert and vice president of government programs at MVP Health Care, a health insurance provider with locations in New York and Vermont.

Medicare beneficiaries often choose to enroll in a Medicare Part C plan if Original Medicare doesn’t cover all that they need, such as vision or prescription drug coverage, adds Collins.

Medicare Part C covers all services Medicare Part A and Part B cover, including:

• Inpatient hospital care, skilled nursing facility care and home health care
• Approved services from doctors and other health care providers, outpatient care, durable medical equipment (such as wheelchairs, walkers and hospital beds) and preventative services (like yearly wellness visits, vaccines and medical screenings)

Most Medicare Part C plans also cover services beyond what’s available under Original Medicare, which can include (but are not limited to):

• Prescription drug coverage (Medicare Part D)
• Dental care, including dental exams, teeth cleanings and X-rays
• Vision services, including routine eye exams and glasses
• Hearing services, such as hearing tests and hearing aids
• Wellness benefits like gym memberships and other health programs

Unlike Medicare Part A and Part B, which allow beneficiaries to see any medical provider who accepts Medicare in the U.S., Medicare Advantage plans require beneficiaries to use providers within that plan’s network if they want to avoid additional out-of-pocket expenses.

“It’s also essential to remember that not all Medicare Advantage plans are alike,” says Collins. The specific services covered and the costs associated with those services can vary significantly from plan to plan,” says Collins.

Plan benefits can also change each year, so it’s crucial to review plans annually to determine the best fit regarding health care needs and budget, he adds.

The cost of Medicare Part C can vary widely depending on several factors, including the specific plan, the plan provider and the beneficiarie’s location, explains Collins.

Part C beneficiaries must pay the monthly Medicare Part B premium—$164.90in 2023 excluding a potential income-related monthly adjustment amount (IRMAA). Although, some Medicare Part C plans help cover some or all of the costs of Part B premiums.

Meanwhile, Medicare Part C plans come with their own monthly premiums. Monthly premiums for Medicare Part C plans generally cost between $0 and approximately $200.

Below are some examples of Medicare Part C plans available to Medicare beneficiaries located in ZIP code 60629 in Chicago, Illinois, and their associated costs.

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“Assessing which Medicare Advantage plan is best can be confusing, as some [beneficiaries can choose from] up to 50 different plans,” says Collins.

He recommends beneficiaries understand their health and financial needs before evaluating plans. Before shopping, consider the following questions:

• What’s my budget, including monthly premiums, deductibles, coinsurance and copays?
• Do my doctors accept this plan, or am I willing to change health care providers?
• Are my medications covered? Are there any medications I may need in the near future, and are they covered?
• What’s the cost of my medications on this plan? Is there a deductible for my medications?
• Does the plan cover the supplemental benefits I need, such as dental, vision or hearing care?
• What’s the plan’s star rating from the Centers for Medicare and Medicaid Services?

“Working with an industry expert can help Medicare beneficiaries navigate the process of finding the best plan for their situation,” adds Collins. “A good Medicare or insurance advisor listens, understands the individual’s unique needs and empowers them to make the right health care decision for themselves.”

Medicare Part A and Part B beneficiaries can apply for Medicare Part C during certain times known as enrollment periods.

• Initial enrollment period: This period begins three months before a person becomes eligible for Medicare (typically by turning 65) and ends three months after the month in which they become eligible (typically their birthday month).
• Annual open enrollment period: During this period, which runs from October 15 to December 7 each year, any Medicare beneficiary can join or switch Medicare Part C plans.
• Medicare Advantage open enrollment period: Those already enrolled in a Medicare Part C plan can switch to another Part C plan during this period, which runs from January 1 to March 31 each year.
• Special enrollment periods: Those who experience certain life-changing events (like moving, losing a job or experiencing a significant change in health status) may qualify for a special enrollment period, during which they can join or switch to another Medicare Part C plan.

To apply for a Medicare Advantage plan, visit Medicare.gov, call 1-800-MEDICARE (1-800-633-4227) or contact a private insurance company that offers Medicare Part C plans.