Medicare Part C
Updated September 2026 · 2026 figures from CMS and Medicare.gov
Medicare Part C is Medicare Advantage: private health plans approved by Medicare that provide your Part A and Part B benefits instead of Original Medicare. Most include Part D drug coverage and some extras, and all have a yearly out-of-pocket limit.
How Part C works
You stay in Medicare and keep paying your Part B premium, but a private insurer handles your coverage and claims. Medicare pays the insurer a fixed amount each month to cover your care. You use the plan's card, not your red-white-and-blue Medicare card.
Types of Part C plans
- HMO (Health Maintenance Organization): in-network doctors only, except emergencies; usually needs referrals to see specialists.
- PPO (Preferred Provider Organization): you can go out of network for a higher cost.
- PFFS (Private Fee-for-Service): any provider who accepts the plan's terms.
- SNP (Special Needs Plans): for people with certain chronic conditions, living in institutions, or with both Medicare and Medicaid (D-SNPs).
- MSA (Medical Savings Account): a high-deductible plan with a deposit you can use for care.
What Part C covers
Everything Original Medicare covers except hospice (which Original Medicare still pays for). Most plans add Part D drug coverage, and many offer some dental, vision, hearing or fitness benefits. Plans can use prior authorization and networks that Original Medicare doesn't.
What Part C costs
- Your Part B premium ($202.90 a month in 2026 for most people)
- The plan's own premium — many plans charge $0
- Deductibles, copays and coinsurance, up to the plan's yearly out-of-pocket maximum for Part A and B services
When you can join, switch or leave
| Enrollment period | Dates | What you can do |
|---|---|---|
| Initial Enrollment Period | 7 months: 3 months before your 65th-birthday month, that month, and 3 months after | Sign up for Parts A and B, and join a Part D or Medicare Advantage plan |
| General Enrollment Period | January 1 – March 31 | Sign up for Part A/B if you missed your window; coverage starts the next month; late penalties may apply |
| Special Enrollment Period | Up to 8 months after job-based coverage (or the job) ends | Sign up for Part B without a penalty |
| Annual Open Enrollment | October 15 – December 7 | Switch between Original Medicare and Medicare Advantage, or change drug plans; changes start January 1 |
| Medicare Advantage Open Enrollment | January 1 – March 31 | If you're in a Medicare Advantage plan: switch to another one, or go back to Original Medicare |
| Medigap Open Enrollment | 6 months from the month you're 65+ and have Part B | Buy any Medigap policy sold in your state with no medical questions |
You need Parts A and B and must live in the plan's service area. You can't use a Medigap policy with a Medicare Advantage plan.
For a side-by-side comparison with Original Medicare, see Medicare Advantage vs Original Medicare.
Frequently asked questions
What is Medicare Part C?
Another name for Medicare Advantage: private plans that provide your Part A and B benefits, usually with drug coverage.
Is Part C the same as Medicare Advantage?
Yes.
Do I still pay Part B with Part C?
Yes. You keep paying your Part B premium, plus any plan premium.
Can I have Part C and Medigap?
No. Medigap policies only work with Original Medicare.