Medicare Advantage (Part C)
What Is Medicare Advantage?
Medicare Advantage is a way to get your Medicare Part A and Part B coverage through a private insurance company that contracts with Medicare.
How Medicare Advantage works
When you join a Medicare Advantage plan, the plan provides your hospital and medical coverage instead of Original Medicare. You still have Medicare.
- Plans must cover all medically necessary services that Original Medicare covers. (Hospice care is still covered by Original Medicare.)
- Many plans use a network of doctors and hospitals, and some require referrals to see specialists.
- What each plan covers and costs varies. A licensed insurance agent can go over plan details with you.
Types of Medicare Advantage plans
| Plan type | How it generally works |
|---|---|
| HMO (Health Maintenance Organization) | You generally use doctors and hospitals in the plan’s network, except in emergencies. You may need a referral to see a specialist. |
| PPO (Preferred Provider Organization) | You pay less when you use in-network providers, and you can see out-of-network providers, usually at a higher cost. |
| PFFS (Private Fee-for-Service) | The plan sets how much it pays providers. You can see any provider who accepts the plan’s terms. |
| SNP (Special Needs Plan) | For people with certain chronic conditions, who live in an institution, or who have both Medicare and Medicaid. |
Medicare Advantage vs. Original Medicare
| Topic | Original Medicare | Medicare Advantage |
|---|---|---|
| Doctors and hospitals | Any provider in the U.S. that accepts Medicare | Often a network; rules vary by plan |
| Medicare Supplement (Medigap) | Can be added | Can’t be used with Medicare Advantage |
Who can join?
You can join a Medicare Advantage plan if you have Medicare Part A and Part B and live in the plan’s service area.
When can you join or switch?
- Initial Enrollment Period, when you first become eligible for Medicare
- Annual Enrollment Period, October 15 – December 7 (coverage starts January 1)
- Medicare Advantage Open Enrollment, January 1 – March 31, for people already in a Medicare Advantage plan
- Special Enrollment Periods, after certain life events
Reviewed October 2026. Medicare rules and costs change every year. For the latest official information, visit Medicare.gov or call 1-800-MEDICARE (TTY 1-877-486-2048).
FAQ
Medicare Advantage questions
Can I keep my doctor?
It depends on the plan, and many Medicare Advantage plans use networks. A licensed insurance agent can go over this with you.
Can I have Medicare Advantage and a Medicare Supplement plan?
No. Medicare Supplement plans can’t be used to pay costs in a Medicare Advantage plan.
Questions about Medicare? Talk with a licensed agent.
Mon–Fri, 8 a.m.–6 p.m. ET · TTY: +1 877-486-2048