If you’re eligible for Medicare—or will be soon—you may have wondered about Medicare Advantage.

“Since they both share the name ‘Medicare,’ it can be confusing to sort out the differences between the two,” said Ryan Ramsey, Associate Director of Health Coverage and Benefits at NCOA. One of the simplest ways to remember it, he advised, is to think about who provides the coverage:

• Original Medicare (Parts A and B) – the federal government administers your benefits.
• Medicare Advantage (Part C) – a private insurer administers your benefits.

When it’s time to sign up for Medicare coverage, you can join original Medicare or a private Medicare Advantage plan. If you choose Medicare Advantage, you still have Medicare; you just receive your benefits a different way.

This article covers the nuts and bolts of what Medicare Advantage is, how it works, and why some people choose it for their Medicare coverage.

Medicare Advantage: the basics

There are many different types of Medicare Advantage plans, and each functions in a unique way. These plans include:

• Health maintenance organizations (HMOs) – plans that generally limit your coverage and benefits to a defined network of health care providers.
• Preferred provider organizations (PPOs) – plans that offer a broader selection of in- and out-of-network providers, though your costs are lower in-network.
• Special needs plans (SNPs) – can be HMOs or PPOs specifically intended for people who meet narrow eligibility criteria.
• Private fee-for-service (PFFS) plans – plans that pre-negotiate how much they will pay your doctors and other providers for care you receive at Medicare-approved facilities.
• Medicare Savings Accounts (MSAs) – high-deductible plans that include a special vehicle for putting pre-tax money aside to pay for your out-of-pocket costs.

Not all types of Medicare Advantage plans are available in all areas or to all Medicare enrollees. It’s also important to note that if you have Medicare Advantage you can't also have a Medigap (supplemental insurance) policy.

Why choose Medicare Advantage?

Medicare Advantage plans must cover all the same services that original Medicare does. These include hospital stays, short-term nursing home stays, doctor visits, and diagnostic and laboratory tests.

However, Medicare Advantage plans may also offer additional benefits that original Medicare does not provide. These include:

• Vision care and eyeglasses
• Hearing care and hearing aids
• Dental services
• Health club memberships
• Medically necessary transportation

Some Medicare Advantage plans will even provide non-medical benefits such as:

• Special debit cards for groceries
• Help with utility bills
• Credits toward purchasing over-the-counter health items

How much does Medicare Advantage cost per month?

If you enroll in a private Medicare Advantage plan, you will pay a monthly premium for your Pat B (medical) benefits. This premium depends on the insurer and plan you choose and may be as low as $0. The estimated average monthly premium for all Medicare Advantage plans—including those with prescription drug coverage and Special Needs Plans (SNPs)—is $17.00 in 2025.

“Don’t assume this will be the case, though,” Ramsey said. “It’s important to shop around and compare.”

Some plans also charge an additional monthly premium on top of what you pay for Part B. And, for some services, you will be responsible for paying a deductible and a portion of the cost of those services. These extra premiums and cost-sharing helps pay for the additional benefits that some Medicare Advantage plans offer their members.

How the costs are structured varies by the type of plan. If you enroll in Medicare Advantage, you may be eligible to get help paying for your coverage if you qualify for Medicaid or a Medicare Savings Program.

What does Medicare Advantage cover for older adults?

With original Medicare, you can go to any doctor, hospital, or other health-care provider that accepts Medicare. But when you join a Medicare Advantage plan, you must follow the rules of the plan to get your coverage.

For instance, some Medicare Advantage plans require you to stay within a network of providers the plan has contracted with. If you go to a doctor's office or a hospital outside of this network, your plan won’t cover it. Other plans might offer out-of-network coverage, but you’ll pay more money out-of-pocket for it.

Most Medicare Advantage plans will bundle Part D (prescription drug) coverage into them. Others only offer health coverage; if you want Part D benefits, too, you will need to purchase a separate Part D drug plan to cover your medications.

How do I enroll in Medicare Advantage?

There are several specific enrollment periods during the year when you’re allowed to sign up for, change, or drop a Medicare Advantage plan. These are:

Initial Enrollment Period (IEP)
Ongoing

If you are newly eligible for Medicare based on your age (you are turning 65) or a qualified disability, you can select a Medicare Advantage plan during this time. Your IEP depends on your birthday month and/or whether you have met a 24-month waiting period following a disability determination. Learn more.

Medicare Advantage Open Enrollment Period
Jan. 1 – March 31

During this time, you may make a one-time decision either to change your existing Medicare Advantage plan to a different one, or to drop your Medicare Advantage plan and enroll in original Medicare instead. Learn more.

Annual Open Enrollment Period
Oct. 15 – Dec. 7

If you have original Medicare, and want to switch to a Medicare Advantage plan, you can do that during Open Enrollment. You also may do the reverse: change from original Medicare to a Medicare Advantage plan. Finally, you can switch your existing Medicare Advantage plan to a different one. Learn more.

Special Enrollment Periods
Ongoing

Sometimes, your life circumstances change. If you move away from the area covered by your Medicare Advantage plan, if your income changes, if you experience a government-declared disaster, or if you made a mistake when first signing up, you have the opportunity to change your plan. Learn more.

Get help understanding your Medicare Advantage options

There are many factors to explore if you’re thinking about enrolling in a Medicare Advantage plan. Talking to trusted friends, family members, and others you may know about their experiences can help.

You also can contact the local office of your State Health Insurance Assistance Program (SHIP) by calling 1-877-839-2675. SHIPS offer no-cost, unbiased insurance counseling to older adults, their families, and caregivers. You can make an appointment with your local SHIP office to go over coverage options, which should take about 30-40 minutes and could make a huge difference.