Medicare Part C

Medicare Advantage (Part C)

Medicare Advantage, also known as Medicare Part C, is a bundled Medicare plan offered by private insurance companies approved by Medicare. These companies provide all your Part A (hospital insurance) and Part B (medical insurance) coverage, and often include additional benefits. In a Medicare Advantage plan, private insurance companies work with Medicare to offer Parts A and B coverage, along with additional services. Part C plans may also cover services not included in Original Medicare, such as vision, hearing, dental, and wellness programs. As of 2025, approximately 51% of all Medicare beneficiaries are enrolled in Medicare Advantage plans, such as Health Maintenance Organization (HMO) or Preferred Provider Organization (PPO) plans. If you are planning to join a Medicare Advantage Plan, Part C will cover all of your Part A and Part B services. Most Medicare Advantage Plans also include Medicare prescription drug coverage (Part D). Medicare pays a fixed amount for your care each month to the companies offering Medicare Advantage plans. These companies must follow rules set by Medicare, which can change each year. A variety of options are available when you opt for a Medicare Part C plan, including:

• Special Needs Plans (SNPs)
• Medicare Medical Savings Account (MSA) Plans
• Private Fee-for-Service (PFFS) Plans
• Health Maintenance Organization (HMO) Plans
• Preferred Provider Organization (PPO) Plans

Medicare Part C covers:

A standard Medicare Part C plan covers everything included in Parts A and B, along with added benefits. Medicare Part A covers inpatient care, and Medicare Part C also includes these benefits:

• Hospital care
• Skilled nursing facility care
• Home health care

Medicare Part C may have different cost-sharing amounts for inpatient and home health care compared to Original Medicare. Under Medicare Advantage, hospice care is generally covered by Original Medicare. Under Original Medicare, outpatient care is covered by Part B. Medicare Part C covers the same benefits as Part B, including:

• Doctor visits (primary care and specialists)
• Laboratory tests and X-rays
• Ambulance services in emergencies
• Inpatient and outpatient mental health services
• Durable medical equipment (such as walkers and wheelchairs)
• Preventive tests and vaccines, including flu shots
• Physical therapy
• Occupational therapy
• Speech and language pathology

Medicare Part C may have different cost-sharing amounts for outpatient care than Original Medicare.

Medicare Part C Costs

Various factors determine Medicare Part C costs, including deductibles, copayments, premiums, and coinsurance. Monthly premiums can range from $0 to higher amounts, depending on the plan and coverage. In 2025, the average monthly Medicare Advantage plan premium is projected to be $17.00. However, you must also continue to pay your Part B premium. Costs associated with Medicare Part C plans may include:

• Monthly plan premiums
• Coinsurance
• Deductibles
• Part B premiums
• In-network deductibles
• Copayments

Medicare Part C Enrollment

The Initial Enrollment Period (IEP) for Medicare Part C starts three months before you turn 65 and ends three months after the month you turn 65. During this period, you can enroll in:

• Medicare Parts A and B
• Medicare Part C (Medicare Advantage)
• Medicare Part D (prescription drug coverage)

Medicare Part C Eligibility

To enroll in Medicare Part C, you must meet the following conditions:

• Currently enrolled in Original Medicare (both Parts A and B)
• Reside in the plan’s service area
• Enroll during an applicable enrollment period

Medicare Part C Premiums

Medicare Part C premiums vary based on the plan and coverage selected. In 2025, the average monthly premium for Medicare Advantage plans is projected to be $17.00. Private companies offer different Medicare Advantage plan types, which may differ in coinsurance, deductibles, and out-of-pocket limits. It’s important to review your medical costs from the previous year to determine the cost-effectiveness of a Medicare Part C plan.