Medicare Advantage · Part C
Medicare Advantage, explained honestly
Medicare Advantage (Part C) is an all-in-one alternative to Original Medicare. Instead of receiving your Medicare benefits directly from the government, with Medicare Advantage you…
Many plans have $0 monthly premiums, though you still pay your Part B premium ($202.90/mo in 2026) to the government. Many also include extra benefits such as dental, vision, and hearing.
Types of Plans
HMO: Must use in-network providers. Requires a primary care doctor and referrals.
PPO: Can see out-of-network providers at higher cost. More flexibility.
SNP: Tailored for people with specific chronic conditions or dual Medicare/Medicaid eligibility.
Plans Change Every Year, Yours Included
Medicare Advantage plans are approved by Medicare every year, and carriers are allowed to change nearly every detail of the plan for the following plan year. None of this requires your consent — which is exactly why a review matters.
What to Check Every Year
Network: Are your doctors, specialists, and preferred hospital still in-network? Networks shrink more often than people expect.
Formulary: Are your prescriptions still covered, and at the same tier? A medication moving up a tier can significantly raise your cost.
Star rating: Has your plan's quality rating dropped? A falling rating can be an early signal of service or coverage issues.
Out-of-pocket maximum: This cap can increase year to year, changing your worst-case financial exposure.
Extra benefits: Dental, vision, hearing, and OTC allowances are often the first things carriers trim or restructure.
Referral and prior authorization rules: Some plans add new requirements for services that were previously unrestricted.
Already enrolled and wondering if your plan still fits? Start with a free plan review.
Not sure whether Advantage or Medigap fits your life? That's exactly what a free consultation answers.
Medigap vs. Medicare Advantage
| Feature | Medigap | Medicare Advantage |
|---|---|---|
| Monthly Premium | Varies by plan type, age, gender, location | Often $0 (still pay Part B) |
| Networks | Any doctor accepting Medicare | In-network only |
| Referrals | Never needed | Required |
| Out-of-Pocket Max | Very low (Plan G: ~$283/yr) | Up to $9,250 in-network, $13,900 out-of-network |
| Drug Coverage | Separate Part D plan needed | Usually included |
| Extra Benefits | Foreign travel coverage | Dental, vision, hearing, gym |
| Flexibility to Travel | Excellent nationwide | None, limited to service area |
| Paying Claims | Covers everything medically necessary | Ability to deny claims at will |
Compare the Advantage plans in your county
Networks and benefits can differ street by street, wherever you live. An independent advisor checks that your doctors, hospital, and prescriptions are actually covered by the plan you're considering, before you enroll.
The right plan is the one that fits your doctors, drugs, and budget.
Let's check all three. Free, in one conversation.
Mon–Fri 8am–8pm ET · Sat by appointment