Medicare Advantage • Part C
Explore Medicare Advantage options with confidence.
Learn how Medicare Advantage works, understand important differences among plan types, and request personalized guidance about options available in your area.
- Local plan guidance
- Provider & drug review
- Licensed-agent assistance
Start with 3 quick questions
Medicare Advantage availability is local, so we begin with a few basics.
How it works
Medicare Advantage combines Medicare coverage through a private Medicare-approved plan
Medicare Advantage, also called Part C, is another way to receive Medicare Part A and Part B benefits. Most plans also include Medicare drug coverage, and many offer additional benefits.
Keep Medicare Parts A & B
You remain in Medicare, but most covered services are provided through your Medicare Advantage plan.
Review the local network
Doctors, hospitals, pharmacies and service areas can matter. Network rules differ by plan type.
Compare total value
Look beyond premium alone. Review copays, maximum out-of-pocket limits, prescriptions and extra benefits.
Plan structures
Common Medicare Advantage plan types
Your best fit depends on your doctors, prescriptions, travel patterns, health needs and preferred level of flexibility.
Health Maintenance Organization
Usually emphasizes in-network care and may require referrals depending on the plan.
Preferred Provider Organization
Typically provides more flexibility to use out-of-network providers, usually at a higher cost.
Special Needs Plan
Designed for certain qualifying groups, such as people with specific chronic conditions or dual Medicare/Medicaid eligibility.
PFFS / MSA Options
Availability varies. These plan structures have different provider, payment and drug-coverage rules.
What to compare
Don't compare Medicare Advantage plans on premium alone
A plan that looks inexpensive may not be the best fit if your doctors, hospitals or prescriptions do not match its rules.
| Feature to review | Why it matters | Ask before enrolling |
|---|---|---|
| Doctors & hospitals | Networks can affect access and cost | Are my providers in network? |
| Prescription drugs | Formularies and cost tiers vary | Are my medications covered and at what tier? |
| Copays / coinsurance | Costs can differ by service | What will I pay for specialists, hospital care and tests? |
| Maximum out-of-pocket | Caps annual Part A/B cost exposure | What is the plan's annual maximum? |
| Extra benefits | Dental, vision, hearing and other benefits may vary | What is actually included and what are the limits? |
| Travel / out-of-area care | Non-emergency coverage rules differ | How does the plan work when I travel? |
Plan benefits, provider participation, formularies, premiums and cost sharing can change. Verify current details before enrollment.
Medicare at a glance
Understand the four parts of Medicare
Part A
Hospital insurance, including covered inpatient and certain post-hospital services.
Part B
Medical insurance for covered physician, outpatient and other medical services.
Part C
Medicare Advantage: private Medicare-approved plans providing Part A and Part B coverage.
Part D
Prescription drug coverage. Most Medicare Advantage plans include Part D.
Enrollment timing
When can Medicare Advantage coverage be changed?
Enrollment rights depend on your circumstances. Common periods include your initial Medicare eligibility period, the fall Annual Enrollment Period, the Medicare Advantage Open Enrollment Period for current MA members, and certain Special Enrollment Periods.
Annual Enrollment Period
October 15 through December 7 is the annual window when eligible Medicare beneficiaries can make many Medicare Advantage and Part D changes for the next calendar year.
MA Open Enrollment
People already enrolled in Medicare Advantage have a separate annual opportunity to make certain changes. 1 Jan to 31 March
Special Circumstances
Moves, loss of qualifying coverage, Medicaid changes and other events can create Special Enrollment Period rights.
Want help comparing Medicare Advantage options?
Speak directly with Prime Time Health & Wealth.
Common questions
Medicare Advantage FAQs
TPMO Disclaimer: We do not offer every plan available in your area. Currently we represent 12 organizations which offer 16 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
Disclaimer
Prime Time Health & Wealth is not connected with or endorsed by the U.S. government or the federal Medicare program. This page is intended for educational and insurance-marketing purposes. Plan availability and eligibility vary by location and individual circumstances.
TPMO Disclaimer: We do not offer every plan available in your area. Currently we represent 12 organizations which offer 16 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
Final Medicare marketing language, privacy language, contact-consent language, and carrier-specific requirements should be reviewed and approved for the specific organizations, plans, states, advertising channels and lead-generation methods used before publication.