Discover everything you need to know about Medicare Advantage (Part C) plans for 2025. From enhanced benefits and lower costs to new coverage options, we'll help you find the perfect plan for your healthcare needs.
2025 limit
Monthly cost
Available nationwide
Americans enrolled
What's New This Year
Medicare Advantage (Part C) is an all-in-one alternative to Original Medicare that's offered by private companies approved by Medicare. It includes everything Original Medicare covers, plus often much more.
Medicare Advantage replaces your Original Medicare Parts A and B. You still have Medicare, but you get your benefits through a private plan instead of directly from the government.
Most plans include prescription drug coverage (Part D) and extra benefits like dental, vision, hearing aids, wellness programs, and transportation.
Most plans use provider networks (HMO, PPO) to manage costs and coordinate care. You'll typically need to use doctors and hospitals in the plan's network for the best rates.
*Most Medicare Advantage plans include Part D prescription drug coverage
Annual out-of-pocket maximum limits protect you from catastrophic medical expenses
Provider networks help coordinate your care and often eliminate referral requirements
Dental, vision, hearing, wellness programs, and other benefits not covered by Original Medicare
One plan, one card, one monthly premium (plus your Medicare Part B premium)
When you join a Medicare Advantage plan, you're still in Medicare. Medicare pays the plan a set amount to cover your Medicare benefits. The plan must follow rules set by Medicare and must cover all the services that Original Medicare covers.
Understanding the different types of Medicare Advantage plans and their costs helps you choose the right coverage for your needs and budget. Here's what you need to know for 2025.
Beyond Part B premium
For medical services
Annual limit (in-network)
CMS limit for 2025
Remember: You still pay your Medicare Part B premium ($185/month in 2025) in addition to any plan premium.
*Original Medicare has no out-of-pocket maximum limit
Health Maintenance Organization
HMO plans typically have lower costs but require you to choose a primary care doctor (PCP) and get referrals for specialist care. You must use providers in the plan's network.
Best For: People who want lower costs, don't mind using a network, and prefer coordinated care through a primary care physician.
PPO plans offer more flexibility to see specialists and out-of-network providers, though at higher costs. No referrals needed and no requirement to choose a primary care doctor.
Best For: People who want flexibility to see any provider, travel frequently, or have established relationships with out-of-network doctors.
Health Maintenance Organization with Point-of-Service option. Like HMO but allows some out-of-network care for higher costs.
PPO plans that serve specific multi-state regions rather than individual states. Often have lower costs than local PPOs.
Specialized plans for people with chronic conditions, dual eligibility (Medicare + Medicaid), or living in institutions.
Important changes and improvements to Medicare Advantage plans this year
Annual out-of-pocket maximum for prescription drugs in Medicare Advantage plans
More plans offering comprehensive dental, vision, and hearing coverage
Permanent coverage for virtual healthcare services and remote monitoring
Increased number of plan choices available in most areas nationwide
Medicare Advantage isn't right for everyone. Here's an honest look at the advantages and disadvantages to help you make an informed decision about your Medicare coverage.
Why Medicare Advantage might be perfect for you
Many plans have $0 monthly premiums and lower out-of-pocket costs than Original Medicare plus Medigap and Part D. Annual out-of-pocket maximum provides cost protection.
Dental, vision, hearing aids, fitness programs, transportation, telehealth, and wellness programs often included at no extra cost.
Provider networks help coordinate your care, reduce duplicate tests, and often provide better management of chronic conditions.
96% of plans include prescription drug coverage, eliminating the need for a separate Part D plan. $2,000 annual drug cap in 2025.
Single plan covers hospital, medical, and prescription drugs. One card, one customer service number, one monthly bill (plus Part B premium).
Many plans offer mobile apps, telehealth services, remote monitoring, and other innovative features not available with Original Medicare.
Potential drawbacks to consider carefully
Must use plan's network of doctors and hospitals for best rates. Out-of-network care can be very expensive or not covered at all.
Plans can change networks, formularies, costs, and benefits annually. Your doctor or medications might not be covered next year.
Coverage often limited to plan's service area. Limited coverage when traveling, except for emergencies. May not be ideal for frequent travelers.
Many services require pre-approval from the plan. This can delay care and create administrative burdens for you and your doctors.
HMO plans require referrals from your primary care doctor to see specialists, potentially delaying care and limiting your choices.
Switching back to Original Medicare can be challenging. You may face medical underwriting for Medigap plans and higher costs.
Want lower monthly costs and are comfortable with network restrictions
Value extra benefits like dental, vision, and wellness programs
Prefer coordinated care and don't mind choosing a primary care doctor
Don't travel frequently or have specific out-of-area doctor preferences
Want prescription drug coverage included in one plan
Are generally healthy or have well-managed chronic conditions
Want the freedom to see any Medicare-accepting doctor or specialist
Travel frequently or spend time in multiple states
Have complex medical needs or prefer specialist-driven care
Value predictable coverage that doesn't change year to year
Are willing to pay higher premiums for maximum flexibility
Don't need extra benefits like dental and vision coverage
Use these questions to guide your Medicare decision
Every person's Medicare needs are different. Our experienced Medicare specialists can help you analyze your specific situation and find the coverage that's perfect for your needs and budget.
Understanding Medicare Advantage enrollment periods is crucial for getting the coverage you need when you need it. Missing these deadlines could mean waiting months for coverage or facing penalties.
The most important enrollment period for current Medicare beneficiaries
This annual period allows all Medicare beneficiaries to make changes to their Medicare coverage for the following year.
All changes take effect
This is your guaranteed opportunity to make changes regardless of health status
Missing this period may mean waiting until next year to make changes
Check if your doctors, hospitals, and medications are still covered
Look at premiums, deductibles, and out-of-pocket maximums
See what dental, vision, and wellness benefits are available
Additional opportunity for Medicare Advantage members only
This period is specifically for people who are already enrolled in a Medicare Advantage plan and want to make a change.
Only people currently enrolled in a Medicare Advantage plan
Changes take effect the first day of the month after your enrollment is processed
You can only use this period once per year
Not available if you're in Original Medicare or a Medigap plan
Gives you a chance to experience your new MA plan and make adjustments if it's not meeting your needs.
If you're still working and have employer health insurance, you may be able to delay enrollment without penalties.
Year-round opportunities based on qualifying life events
Special circumstances can trigger enrollment opportunities outside of regular enrollment periods. These are typically available for 2-3 months from the qualifying event.