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Medicare Part C (Medicare Advantage)

What is Medicare Part C (Medicare Advantage)?

Medicare Part C — or Medicare Advantage — plans offer Medicare-covered benefits through private health plans instead of through Original Medicare.

The plans are required to offer the benefits that are covered by Medicare Part A and Part B, but they can also offer additional benefits, such as prescription drug coverage (90 percent of Medicare Advantage plans include prescription coverage in 2019), or dental and vision coverage. Starting in 2019, the federal government is allowing Medicare Advantage plans to provide additional benefits that were previously not allowed, and that flexibility will expand even more in 2020.

Although Medicare Advantage plans typically provide coverage that goes beyond just Medicare Parts A and B, coverage is typically limited to a local network of providers, rather than the broad, nationwide access to providers that Original Medicare beneficiaries have.

Medicare Advantage enrollees pay the premium for Part B ($135.50/month in 2019 for most enrollees), plus the premium for their Medicare Advantage plan. As of 2019, the average Medicare Advantage premium was $34/month, but that included the 51 percent of Medicare Advantage enrollees who had zero-premium plans (ie, they only had to pay their Medicare Part B premiums, as their Advantage plan didn’t have a premium). Among the 49 percent of Advantage enrollees who did have a monthly premium for their Advantage plan (in addition to their monthly premium for Medicare Part B), the average premium was $70/month in 2018.

34 percent of all Medicare beneficiaries were enrolled in Medicare Advantage plans in 2018, with the remaining two-thirds enrolled in Original Medicare.

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