Medicare Advantage (Part C) — What You Need to Know

Medicare Advantage, also called Medicare Part C, is a type of health insurance plan offered by private companies that are approved by Medicare. These plans must provide at least the same coverage as Original Medicare (Parts A and B) — and often include extra benefits like prescription drug coverage (Part D), dental, vision, and more.

Many plans offer these added benefits at no additional premium, since Medicare pays these insurers directly to manage your care.

Let’s explore everything you need to know about eligibility, enrollment, coverage, and costs.




✅ Medicare Advantage Eligibility Requirements

Requirement Details
Medicare Enrollment Must be enrolled in both Part A and Part B
Citizenship Must be a U.S. citizen or lawful permanent resident (5+ years)
Residency Must live in the plan’s service area at least 6 months/year
ESRD Eligibility People with ESRD are eligible since 2021
Part B Premium You must continue paying your Part B premium


🗓️ Medicare Advantage Enrollment Periods

Enrollment Period When It Happens What You Can Do
Initial Enrollment Period (IEP) 3 months before to 3 months after turning 65 Enroll in Medicare Advantage for the first time
Annual Enrollment Period (AEP) October 15 – December 7 Add, switch, or drop a Medicare Advantage plan
Medicare Advantage Open Enrollment January 1 – March 31 Switch plans or return to Original Medicare
Special Enrollment Period (SEP) Varies — based on life events like moving Make changes outside of standard enrollment periods




🩺 What Medicare Advantage Covers

Medicare Advantage plans must include everything covered by Original Medicare — and they often offer more:

  • Inpatient hospital care

  • Doctor visits and outpatient care

  • Emergency and urgent care

  • Mental health services

  • Home health care (non-hospice)

  • Prescription drug coverage (in most plans)

  • Dental, vision, and hearing benefits

  • Fitness programs (like SilverSneakers)

  • Worldwide emergency travel benefits

  • Over-the-counter (OTC) allowances

📝 Benefits vary by plan. Always review your plan’s Summary of Benefits for full details.




💵 How Much Does Medicare Advantage Cost?

Your costs depend on the specific plan, your location, and how much care you use.

  • $0 Premium Plans: Many areas offer plans with $0 premiums — but you must still pay your Part B premium

  • Deductibles: Some plans have no deductibles; others have separate drug and medical deductibles

  • Copays/Coinsurance: You may pay a fixed fee or a percentage for services

  • Out-of-Pocket Maximum: All Medicare Advantage plans have a spending cap — a major benefit over Original Medicare

  • Income Consideration: If your income is high, you may pay IRMAA surcharges on Part B and Part D




🤔 Is Medicare Advantage Right for You?

Medicare Advantage plans offer more all-in-one convenience, cost protections, and extra perks — but networks and coverage can vary.

When deciding, consider:

  • Your preferred doctors and hospitals

  • Prescription needs

  • Budget and income

  • Desire for extras like dental, vision, or gym memberships




How Graham Life Services Can Help

Choosing the right Medicare Advantage plan doesn’t have to be overwhelming. At Graham Life Services, our licensed agents:

  • Explain the benefits of Medicare Advantage in plain language

  • Compare local plans to find what suits you best

  • Help you avoid unnecessary costs and enrollment mistakes

  • Guide you every step of the way — at no cost to you

📞 Reach out for a free consultation and explore your Medicare Advantage options with confidence.

Read our Blog

Book an Appointment

Not Sure What Coverage You Need?

Get expert help—schedule a quick call with us.

Check Out Our Other Blogs

Share this:

Like this:

Like Loading...

Discover more from Graham Life Services

Subscribe now to keep reading and get access to the full archive.

Continue reading