Medicare Part C (Medicare Advantage) covers what Original Medicare covers. Many Part C plans also offer dental, vision, and hearing coverage. Part C is managed by private insurance companies that set the costs.

Original Medicare and Medicare Part C (Medicare Advantage) are different insurance options with different costs. If you’re eligible for Original Medicare but want additional coverage for prescription drugs and other services, Medicare Part C might be a good option for you.

Several factors determine Medicare Part C costs, such as:

  • premiums
  • deductibles
  • copayments
  • coinsurance

These amounts can range from $0 to hundreds of dollars for monthly premiums and yearly deductibles.

In this article, we’ll explore Medicare Part C costs and the factors that contribute to them and compare a few plan costs from around the United States.

Most of your Medicare Part C costs will be determined by the plan you choose. However, your lifestyle and financial situation can also have an impact on your costs.

Here are some of the most common factors that affect what you’ll pay for a Medicare Part C plan:

  • Premiums: Some Medicare Part C plans are “free,” meaning they don’t have a monthly premium. Even with a zero-premium Medicare Advantage plan, you may still owe the Part B premium.
  • Deductibles: Most Medicare Part C plans have both a plan deductible and a drug deductible. Many (but not all) of the free Medicare Advantage plans offer a $0 plan deductible.
  • Copayments and coinsurance: Copayments are amounts you’ll owe for every doctor’s visit or prescription drug refill. Coinsurance amounts are any percentage of services you must pay out of pocket after your deductible has been met.
  • Plan type: The type of plan you choose can also have an impact on how much your Medicare Part C plan may cost. For example, if you’re on an HMO or PPO plan but choose to visit an out-of-network provider, this can increase your costs.
  • Out-of-pocket max: One advantage of Medicare Part C is that all plans have an out-of-pocket maximum. This amount varies but can range from the low thousands to upward of $10,000-plus.
  • Lifestyle: While Original Medicare covers services nationwide, most Medicare Advantage plans are location-based. This means that if you travel often, you may find yourself stuck with out-of-town medical bills.
  • Income: Your yearly gross income can also factor into how much you’ll pay for your Medicare Part C costs. For people with a lack of income or resources, there are programs that can help lower your Medicare costs.

Managing Part C costs

One of the first things you can do to manage your Medicare Part C costs is to read through the following annual notices from your plan:

  • evidence of coverage (EOC)
  • annual notice of change (ANOC)

These notices can help you determine exactly what costs you’ll pay out of pocket for your plan, as well as any price changes that will take effect the following year.

Medicare Part C plans have different costs. Your costs may vary depending on your coverage, plan type, and whether you receive additional financial assistance.

Below is a small sample of Medicare Part C plan costs from major insurance providers in cities around the United States:

Plan name CityMonthly
premium
Health deductible, drug deductiblePrimary doctor copaySpecialist copayOut-of-pocket max
Anthem Select (HMO)Los Angeles, CA$0 $0, $0 $0$0$800 in network
Cigna Preferred Medicare (HMO)Denver, CO $0$0, $0$0$25$3,860 in network
Humana Choice H5216-356 (PPO)Dane, WI$0$750, $200$0$35$4,200 in network, $9,550 in and out of network
Humana Gold Plus H0028-042 (HMO)Harris, TX$0$0, $0$0$20$3,450
in network
Aetna Medicare Premier Plan (PPO)Nashville, TN $0$0, $0$0$35$6,350 in network, $7,350 in and out of network
Kaiser Permanente Medicare Advantage Standard MD (HMO-POS)Baltimore, MD$27$0, $0$5$35$6,900 in network

The estimates above are for 2024 and are only a sampling of the many plan options offered in each area.

For a more personal estimate of Medicare Part C plan costs based on your individual healthcare situation, visit this Medicare.gov plan finder tool and enter your ZIP code to compare plans near you.

Is Medicare Advantage more expensive than Original Medicare?

While it may seem that Medicare Advantage plans cost more than Original Medicare, they can actually help reduce medical expenses.

A 2017 study that compared Medicare Advantage to Original Medicare found that physician costs were lower for people who were enrolled in Medicare Advantage plans. In addition, Medicare Advantage plan beneficiaries saved more money on things like medical equipment and lab tests.

Most companies offering Medicare Part C plans have various ways to pay your premium. These options include:

Help paying for Medicare

If you’re having trouble paying your Medicare Part C costs, there are resources that can help:

  • Medicaid: This program helps people with low income pay for medical costs.
  • Medicare savings program (MSP): This benefit helps Medicare beneficiaries with low-income pay plan costs, such as premiums and copayments.
  • Supplemental Social Security: Some individuals can apply for Supplemental Social Security benefits, which are monthly payments that can help pay for Medicare costs.
  • PACE: This is a program that can help you get coordinated care within your local community.
  • Extra Help: If you meet certain income and resource limitations, you may qualify for this Medicare program, called Extra Help, to pay for prescription drug costs, premiums, deductibles, and more.

Medicare Part C (Medicare Advantage) is a great coverage option for Medicare beneficiaries who are looking for additional coverage. Your Medicare Part C costs will include premiums, deductibles, copayments, and coinsurance. Your costs will also be determined based on your plan type, how often you need medical services, and what type of doctors you see.

If you’re age 65 or older or have certain disabilities, you’re eligible to apply for Medicare. Visit the Social Security Administration website for more information on how to apply and enroll.

Medicare plan options and costs are subject to change each year.