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Medicare Advantage Plans 2026

Last reviewed: June 2026 · Reviewed by Galit Sacajiu MD, MPH

Medicare Advantage (Part C) lets you get your Medicare coverage through a private insurer approved by Medicare. The plan must cover everything Original Medicare covers, and most plans add benefits like dental, vision, hearing, and prescription drugs.

More than 34 million Americans — over half of all Medicare beneficiaries — are enrolled in Medicare Advantage as of 2026. Plans are offered by insurers like UnitedHealthcare, Humana, Aetna, and Blue Cross Blue Shield, among many others. The average monthly premium is $14, and many plans are available for $0 per month on top of your standard Part B premium.

What Medicare Advantage Covers

Every Medicare Advantage plan must cover all Part A and Part B services. Most plans go further and include:

💊Prescription drugs (Part D)
🦷Dental care
👁️Vision care
👂Hearing aids
🏋️Fitness programs
🚗Transportation benefits
🏠Home modification benefits
🥗Meal delivery (post-hospital)
🩺Telehealth visits

Extra benefits vary by plan and location. Not every plan offers every benefit listed above.

Plan Types

HMO (Health Maintenance Organization)

You must use providers in the plan's network for non-emergency care. You typically need a referral to see a specialist. HMOs generally have the lowest premiums and out-of-pocket costs.

PPO (Preferred Provider Organization)

You can see any Medicare-accepting doctor, in or out of network. Out-of-network care costs more, but no referrals are required. PPOs offer more flexibility at a higher monthly premium.

SNP (Special Needs Plan)

Designed for people with specific chronic conditions (Chronic SNPs), people who are institutionalized (I-SNPs), or people eligible for both Medicare and Medicaid (D-SNPs). These plans tailor their benefits and drug formularies to the specific needs of their members.

PFFS (Private Fee-for-Service)

The plan sets its own payment rates. Any Medicare-approved provider who agrees to the plan's terms can treat you. Less common than HMO and PPO options.

2026 Costs

CostAmount
Average monthly plan premium$14.00
Plans available at $0/monthMany — varies by region
Maximum out-of-pocket (in-network)Up to $9,350
Maximum out-of-pocket (in + out of network)Up to $14,000
Part B premium (still required)$202.90/month

You continue paying your Part B premium ($202.90/month for most people) even when enrolled in Medicare Advantage. Some plans offer a Part B giveback benefit that reduces this premium.

How to Compare Plans

Plan availability and quality vary significantly by ZIP code. When comparing options in your area, look at these factors:

Network
Confirm your current doctors and specialists are in-network before you enroll. The plan's provider directory is the only reliable source — don't rely on what a sales agent tells you.
Star rating
CMS rates plans 1 to 5 stars for quality and member satisfaction. Look for plans with 3.5 stars or higher. Five-star plans allow enrollment year-round.
Drug formulary
If you take regular prescriptions, run your drug list through the plan's formulary checker. Some specialty drugs are only partially covered or placed on expensive tiers.
Out-of-pocket maximum
This is the most important cost number. Lower is better. Once you hit this limit, the plan pays 100% for the rest of the year.
Copays vs. coinsurance
Some plans charge flat copays per visit. Others charge a percentage (coinsurance) of the allowed amount. For people who need frequent or expensive care, flat copays are more predictable.
Extra benefits
Dental, vision, and hearing coverage varies widely. Some plans offer meaningful dental (crowns, root canals) while others only cover cleanings. Read the details, not just the headline.

Medicare Advantage vs. Original Medicare

Medicare AdvantageOriginal Medicare + Medigap
Monthly costOften $0 plan premiumPart B + Medigap ($100-$300+/mo)
Doctor choiceIn-network (HMO) or any (PPO)Any Medicare-accepting doctor in the U.S.
Out-of-pocket riskCapped annually (up to $9,350)Capped by Medigap plan
Drug coverageUsually includedSeparate Part D plan required
Dental/VisionOften includedNot included
Prior authorizationOften requiredNot required
Best forPeople who want one plan, want extrasPeople who travel, want any doctor

When You Can Enroll

Initial Enrollment Period7-month window around your 65th birthday

The best time to enroll. You can join an Advantage plan when you first become eligible for Medicare.

Annual Enrollment Period (AEP)Oct 15 to Dec 7 each year

Open to everyone on Medicare. You can join, switch, or drop an Advantage plan. Changes take effect Jan 1.

Medicare Advantage Open EnrollmentJan 1 to Mar 31 each year

If you're already in an Advantage plan, you can switch once or return to Original Medicare. New enrollments not permitted.

Special Enrollment PeriodVaries by qualifying event

Moving, losing other coverage, gaining/losing Medicaid, or other qualifying events can trigger a special window to enroll or switch.

Frequently Asked Questions

Is Medicare Advantage the same as Medicare?+

Medicare Advantage is a way to get your Medicare benefits through a private insurer instead of through the federal government directly. You still have Medicare. The plan covers at least everything Original Medicare covers, and usually more. You pay premiums to the private insurer rather than (or in addition to) the standard Part B premium.

Can I keep my doctor with Medicare Advantage?+

It depends on the plan type and your doctor. HMO plans require you to use in-network providers. PPO plans let you see out-of-network doctors but at a higher cost. Before enrolling, check the plan's provider directory to confirm your primary care doctor and key specialists are in-network.

What happens if I need care when traveling?+

Most HMO plans only cover emergency and urgent care outside your service area. PPO plans give you more flexibility. If you travel frequently or split time between states, a PPO or a traditional Medicare plus Medigap combination gives you broader access to care.

Can I switch Medicare Advantage plans?+

Yes, during the Annual Enrollment Period (Oct 15 to Dec 7) you can switch plans, drop Advantage and return to Original Medicare, or join Advantage for the first time. There is also a Medicare Advantage Open Enrollment Period from Jan 1 to Mar 31 where you can make one change.

Do Medicare Advantage plans cover prescriptions?+

Most do. Plans that include drug coverage are called MAPD plans (Medicare Advantage Prescription Drug plans). A small number of plans do not include drug coverage, in which case you can enroll in a standalone Part D plan. Always verify drug coverage before you enroll.

What is a Medicare Advantage star rating?+

CMS rates each Medicare Advantage plan on a 1 to 5 star scale based on quality of care, customer service, member experience, and health outcomes. Five-star plans are rare and allow enrollment at any time of year. Aim for plans rated 3.5 stars or higher.

Find Plans by State

Plan availability, premiums, and networks vary by county. Select your state to see what's available where you live.