Medicare Advantage plans, also called Medicare Part C, are private Medicare-approved plans that replace Original Medicare as your main coverage and often include drug coverage and extra benefits. For 2026, the most important comparison points are provider networks, prescription coverage, premiums, copays, maximum out-of-pocket costs, and annual benefit changes. The Big 65 can help you compare Medicare Advantage plans with a licensed Medicare broker before you enroll or switch plans.
Medicare Advantage Plans were created by combining Part A (Hospital Coverage), Part B (Physician Services), and often Part D (Prescription Drug Coverage) into one plan. These plans offer comprehensive healthcare insurance with a strong emphasis on preventive healthcare services and copays with maximum out-of-pocket costs for Medicare-approved services.
What Is a Medicare Advantage Plan (Part C)?
A Medicare Advantage plan is an alternative way to receive Medicare benefits through a private insurance company approved by Medicare. You still remain in Medicare, but the Advantage plan becomes the primary way your hospital and medical benefits are administered.
A Medicare beneficiary cannot have a Medicare Advantage plan and a Medicare Supplement at the same time. If you are comparing both paths, see our guide to compare Medicare Advantage vs. Medicare Supplement.
How Medicare Advantage Plans Work in 2026
Hospital, medical, and prescription drug coverage
Many Medicare Advantage plans combine hospital coverage, physician services, and prescription drug coverage in one plan. Plans must provide benefits at least as good as Original Medicare for Medicare-approved services, but the way you access care, pay copays, and use providers can differ by plan.
HMO, PPO, PFFS, and Special Needs Plans
Advantage plans include HMO Plans, PPO Plans, PFFS Plans (Private Fee for Service), and SNP Plans (Special Needs Plans). SNP plans were created for Medicare-eligible consumers with certain chronic conditions and specific health needs, such as diabetes, cardiovascular disorders, chronic lung disorders, end-stage liver disease, and other chronic issues.
What to Compare Before Choosing a 2026 Medicare Advantage Plan
Provider networks and doctor access
Hospital and physician networks vary by plan. Use our Medicare Advantage comparison checklist before enrolling to confirm that your doctors, specialists, hospitals, and preferred pharmacies accept the plan you are considering. While Advantage plans typically use a specific network, emergency care is covered outside of the service area within the United States.
Prescription drug formularies and pharmacy costs
If prescription drug coverage is included, compare the plan formulary, drug tiers, prior authorization rules, and preferred pharmacy pricing. A plan that looks inexpensive on premiums may be more expensive if your medications are not covered well.
Premiums, copays, and maximum out-of-pocket limits
Monthly premiums, copays, coinsurance, and maximum out-of-pocket costs can vary from one Medicare Advantage plan to another. Compare the total expected cost, not just the monthly premium.
Dental, vision, hearing, wellness, and other extra benefits
Many Advantage plans offer additional benefits such as dental, vision, hearing, health and wellness programs, and gym memberships. These benefits can be useful, but they should be compared alongside provider access, prescription coverage, and annual plan changes.
Medicare Advantage Enrollment Dates and Annual Plan Changes
Annual Election Period: October 15 through December 7
During the Annual Election Period (AEP), October 15 through December 7 annually, consumers can review their Medicare Advantage options and switch companies if appropriate. Changes made during AEP generally take effect January 1.
Why plans should be reviewed every year
Plan benefits, copays, premiums, drug formularies, and provider networks can change yearly. To make certain your needs are still being met and your providers are still in your network, review your plan before the deadline each year.
Medicare Advantage vs. Medicare Supplement
Medicare Advantage and Medicare Supplement insurance solve different problems. Medicare Advantage replaces Original Medicare as your main coverage through a private plan, while Medicare Supplement works with Original Medicare to help cover certain deductibles, coinsurance, and copayments. Learn more in our Medicare Advantage vs. Medicare Supplement comparison, or review our Medicare Supplement plans page.
Speak With a Licensed Medicare Broker Before You Compare Plans
Comparing Medicare Advantage plans for 2026 is not only about the lowest premium or the longest list of extra benefits. The right fit depends on your doctors, prescriptions, budget, travel needs, and comfort with networks. The Big 65 offers no-pressure, one-on-one Medicare guidance at no additional cost to you.
Questions about Medicare Advantage plans? Call 877-850-0211 or schedule 15 minutes on Karl’s calendar.
Medicare Advantage Plan Help in Your State
The Big 65 is licensed in 33 states and helps clients compare Medicare options by phone and email. If you are looking for state-specific help, start with our Medicare broker pages for Colorado Medicare insurance broker, Texas Medicare insurance broker, Arizona Medicare insurance broker, or California Medicare insurance broker.
Medicare Advantage Plan FAQs
What does Medicare Advantage include?
Medicare Advantage plans, also called Medicare Part C, are offered by private insurance companies and combine Medicare Part A and Part B benefits. Many plans also include Part D prescription drug coverage.
How do Medicare Advantage provider networks work?
Provider networks vary by plan. Before enrolling, confirm that your doctors, hospitals, and preferred pharmacies participate in the plan network.
What costs should I compare before choosing a plan?
Compare premiums, copays, deductibles, maximum out-of-pocket costs, prescription drug coverage, and provider network access.
When can I change Medicare Advantage plans?
Many people review and change Medicare Advantage plans during the Annual Election Period from October 15 through December 7, although other enrollment periods may apply.
Can I have Medicare Advantage and Medigap together?
No. You cannot have a Medicare Advantage plan and a Medicare Supplement plan at the same time.
My explanation of Medicare Advantage Plans