Medicare
Medicare Advantage
Private Part C plans combining A, B (and usually D) with networks, copays, extras, and an annual spending cap.
The quick version
If you only read one thing, read this
- 1
All-in-one coverage often with extras (dental/vision/OTC) and an annual spending cap.
- 2
Often low or $0 premium; pay copays/coinsurance until the plan’s MOOP.
- 3
No underwriting; must enroll during valid election periods (AEP/OEP/Special).
The details
The stuff that matters, one piece at a time
Benefits
All-in-one coverage often with extras (dental/vision/OTC) and an annual spending cap.
What it costs
Show me the money
- Plan Premium Range
- $0–$70+ USDMany $0 HMO options
- In-Network MOOP Range
- $3,500–$9,250 USDFederal max $9,250 for 2026
- Part B Premium Still Owed
- $202.90 USDMust pay Part B premium in addition to plan premium
The honest take
What's good, and where it falls short
The good stuff
- Low or $0 premiums for many plans
- Extra benefits (dental, vision, OTC, fitness) often included
- Annual out-of-pocket cap (MOOP) protects against catastrophic costs
The catch
- Provider networks and prior authorization required
- Benefits, networks, and formularies can change every Jan 1
- Must continue paying Part B premium on top of plan premium
Head to head
Medicare Advantage vs. Medigap
Advantage bundles everything with spending cap; Medigap offers maximum flexibility with a supplement premium.
Buyer beware
The mistakes that cost folks the most
Not re-checking the provider network each year during AEP. Doctors can leave networks every year
Overlooking formulary tier changes for chronic medications that could double or triple your copay
Assuming low premium equals lowest total cost without modeling your expected usage against copays and MOOP
Leaving a Medigap plan for Advantage without understanding you may face underwriting if you try to return
Common questions
What folks ask us most
Keep learning
Watch these next
The Insurance Hawk
Ready to put Medicare Advantage to work?
See the plans and the prices. Or talk it through with a licensed agent who works for you, not the insurance company.