Medicare Advantage (Part C): How It Works and How It Compares to Original Medicare

If you are on Medicare, you may have heard of Medicare Advantage — also called Medicare Part C. It is an alternative to Original Medicare (Parts A and B) that is offered by private insurance companies approved by the federal government. Understanding the difference can help you make a better choice for your health and your wallet.

With Original Medicare, the federal government pays your medical bills directly. You can see almost any doctor or hospital in the country that accepts Medicare. You pay a monthly premium for Part B, plus deductibles and co-pays. Most people also buy a Medigap supplement policy to help cover those extra costs, plus a separate Part D plan for prescription drugs.

Medicare Advantage works differently. Instead of the government paying your bills, you enroll in a plan offered by a private company — like Humana, UnitedHealthcare, or Blue Cross — and that company manages your coverage. You still pay the Part B premium, but the plan itself may have a lower or even $0 additional monthly premium.

Medicare Advantage plans often include extra benefits that Original Medicare does not cover, such as dental care, vision exams, hearing aids, gym memberships, and sometimes transportation to medical appointments. Many plans also include prescription drug coverage. So you do not need a separate Part D plan.

The trade-off is that Medicare Advantage plans usually require you to use a network of doctors and hospitals. If you see an out-of-network provider, you may pay more or the visit may not be covered at all.

You can compare Medicare Advantage plans available in your area using the official Medicare Plan Finder tool at medicare.gov. Open enrollment to change or join a plan runs from October 15 to December 7 each year. You can also switch back to Original Medicare during the Medicare Advantage Open Enrollment period, which runs January 1 through March 31.