How Medicare Advantage (Part C) works
A private plan that delivers your Medicare benefits, with its own rules.
Medicare Advantage plans, also called Part C, are offered by private companies approved by Medicare. If you join one, the plan provides your Part A and Part B coverage instead of Original Medicare, and usually your Part D drug coverage too.
What stays the same
- You're still in Medicare, with the same rights and protections.
- Plans must cover all medically necessary services Original Medicare covers (hospice is still paid by Original Medicare).
- You keep paying your Part B premium.
What's different
- Networks: most plans have networks of doctors and hospitals, and some require referrals.
- Prior authorization: plans often require approval before certain services.
- An out-of-pocket limit: each plan caps what you pay for covered Part A and B services in a year, at no more than $9,250 in-network in 2026.
- Different cost sharing: copays and coinsurance set by the plan, instead of Original Medicare's deductibles and 20%.
- Extra benefits: some plans include limited dental, vision, hearing or other benefits.
- Plans change every year, and are sold by county.
Who can join
You need Part A and Part B and must live in the plan's service area. People with ESRD have been able to join since 2021. You join during your Initial Enrollment Period, fall Open Enrollment (October 15 to December 7), or a Special Enrollment Period.
Before you join
- Check that your doctors, hospitals and pharmacies are in network.
- Check your drugs against the formulary.
- Look at the out-of-pocket limit and costs for services you use.
- Read the Evidence of Coverage for prior authorization and referral rules.
- Understand that returning to Original Medicare with Medigap later may involve health questions.
Common questions
Yes. You still have Medicare; the plan delivers your benefits. Your red, white and blue Medicare card stays valid, though you use your plan's card for care.
No. Medigap only works with Original Medicare.
Yes. Networks can change during the year. Plans must notify you, and some network changes can give you a Special Enrollment Period.
Want help with your own choices?
Every state runs a State Health Insurance Assistance Program (SHIP) with trained counselors who give free, unbiased Medicare help and do not sell plans. Find yours on our Medicare by state pages, or call Medicare at 1-800-MEDICARE (1-800-633-4227) (TTY 1-877-486-2048, 24 hours a day, 7 days a week).
Planning the rest of your coverage in retirement? We can help with life insurance later in life and final expense coverage.
Sources
- Medicare costs, Medicare.gov. Checked September 29, 2026.
- Final CY 2026 Part C Bid Review Memorandum, Centers for Medicare & Medicaid Services. Checked September 29, 2026.
- Joining a health or drug plan, Medicare.gov. Checked September 29, 2026.
General information about the federal Medicare program, not advice about your situation. Figures are for 2026 unless stated and change every year; last reviewed September 29, 2026. Quote My Policy is a private company. Not connected with or endorsed by the United States government or the federal Medicare program.
Quote My Policy does not sell Medicare plans on this site. For plan-specific help, contact Medicare at 1-800-MEDICARE (1-800-633-4227) (TTY 1-877-486-2048, 24 hours a day, 7 days a week) or your State Health Insurance Assistance Program.