Medicare

Medicare Part C (Medicare Advantage)

Medicare Advantage plans deliver all Original Medicare benefits through private insurers and frequently include prescription drug coverage, dental, vision, and hearing benefits.

Last reviewed: May 2026 · Editorial methodology

Definition

Medicare Part C, universally known as Medicare Advantage (MA), is an alternative to Original Medicare in which private insurers contract with CMS to deliver Medicare benefits. Enrollees must still pay the Part B premium ($202.90/month standard in 2026), but the MA plan replaces Original Medicare's cost-sharing structure with the plan's own deductibles, copays, and an annual out-of-pocket maximum — which Original Medicare lacks. Most MA plans include Medicare Part D prescription drug coverage (MAPD plans) and frequently offer supplemental benefits not covered by Original Medicare, such as dental, vision, hearing, fitness memberships, and transportation assistance. MA plans are typically structured as HMOs or PPOs with defined networks; HMO-based MA plans require in-network care except emergencies. CMS assigns Star Ratings (1–5 stars) to MA plans based on quality and performance, with high-rated plans receiving higher federal payments and extra enrollment opportunities. Enrollment in MA has exceeded 50% of Medicare beneficiaries as of 2026, making it the dominant delivery model.

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Glossary definitions are educational. Always check your own policy language — insurers can define common terms differently from one another. When in doubt, request a written explanation from your agent.

Related terms

Medicare Part AMedicare Part A is premium-free for most beneficiaries and covers inpatient care, but comes with significant cost-sharing including a per-benefit-period deductible.Medicare Part BMedicare Part B charges a monthly premium — $202.90 in 2026 for most beneficiaries — and covers the outpatient medical services that Part A does not.Medicare Part DMedicare Part D covers prescription drugs and features a $2,100 out-of-pocket cap in 2026, ending the coverage gap that previously left beneficiaries with full costs.Original MedicareOriginal Medicare provides broad provider access nationwide with no referrals required but lacks an out-of-pocket maximum, making supplemental coverage important.MAPD (Medicare Advantage Prescription Drug)MAPD plans combine the hospital, medical, and drug benefits of Medicare Parts A, B, and D into one integrated plan from a private insurer.Star Ratings (Medicare)CMS Star Ratings help Medicare beneficiaries compare plan quality and affect plan bonus payments and special enrollment eligibility.

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Source: Cover Forge USA editorial team|Last verified: May 2026|Methodology
Definitions are educational and may be simplified. Always refer to your policy contract and consult a licensed agent for terms that affect coverage decisions.
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Cover Forge USA Editorial Team

Editorial Lead

This article was researched and written by the Cover Forge USA editorial team against federal sources (NAIC, CMS, FEMA, DOL, SSA, state DOIs) and standard policy forms. Bylines organize content by topic — they do not assert individual licensure. See our editorial-policy for details.

Reviewed June 2026

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