How Much Does Medicare Part C Cost? Compare Plans & Coverage
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A Medicare Part C plan costs an average of $28 per month. These bundled plans combine benefits for hospital care, medical treatment, doctor visits, prescription drugs and often, add-on coverage for dental, vision and hearing. Keep in mind that what you pay for a Medicare Part C plan will be on top of the cost of Original Medicare.
What is Medicare Part C?
Medicare Part C (also called Medicare Advantage) is a Medicare plan that bundles multiple types of insurance coverage including hospitals, medical care and prescription drugs.
These all-in-one plans are a simplified alternative to Original Medicare, where enrollees get coverage through separate plans: Medicare Part A (hospital and inpatient), Medicare Part B (medical care) and Medicare Part D (prescription drugs).
Medicare Part C plans are offered through private insurance companies and provide coverage that is at least as good as Original Medicare. In other words, if a medical treatment is covered by Original Medicare, then a Medicare Advantage plan must also cover it. But the level of benefits is not always the same between the two.
Part C plans are similar to traditional health insurance because plans have deductibles, copayments and an out-of-pocket maximum. These amounts will vary by plan, and the plan you choose will have a big impact on your medical costs.
What's the average cost of Medicare Part C?
For 2023, the average cost of a Medicare Part C plan with prescription drug coverage is $28 per month.
There's a wide range of plan costs. Many enrollees choose low-cost or free plans, and $0 Medicare Part C plans are available in 49 states. On the high end, some plans can cost several hundred dollars per month. Expensive plans usually provide better benefits such as a broader network of medical providers, more coverage for specialized care or better cost-sharing benefits.
An HMO plan is generally cheaper than a PPO plan. A Medicare Part C HMO plan costs about $20 per month, while local PPO plans average $28 per month.
Cost plans and Private Fee-for-Service (PFFS) plans are the most expensive options. They're only offered in some areas and are usually not worth the high prices.Medicare Part C plan type | # of plans offered | Average monthly cost |
|---|---|---|
| HMO | 1,170 | $20 |
| Local PPO | 652 | $28 |
| Regional PPO | 29 | $65 |
| PFFS | 17 | $79 |
| Cost plan | 12 | $148 |
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Medicare Part C enrollees also pay separately for Original Medicare
Even though Medicare Part C unifies your coverage and benefits, your monthly costs are managed separately. This means Medicare Part C enrollees will pay for Original Medicare (Parts A and B) as well as the cost of a Medicare Part C plan.
- Medicare Part A: Usually free
- Medicare Part B: $165 per month deducted from Social Security
- Medicare Part C: $28 average cost paid to insurance company
Cost of Medicare Part A
Cost of Medicare Part B
Most people get Medicare Part A (hospital insurance) for free because they’ve been in the workforce for at least 10 years and paid Medicare taxes as a payroll deduction.
If you don't qualify for free Medicare Part A, monthly costs can range from $278 to $506 based on how much you or a spouse has already paid in Medicare taxes.
Cost of Medicare Part A
Most people get Medicare Part A (hospital insurance) for free because they’ve been in the workforce for at least 10 years and paid Medicare taxes as a payroll deduction.
If you don't qualify for free Medicare Part A, monthly costs can range from $278 to $506 based on how much you or a spouse has already paid in Medicare taxes.
Cost of Medicare Part B
The rate for Medicare Part B (medical insurance) is set annually. Medicare Part B costs $164.90 per month in 2023. This is usually automatically deducted from your Social Security benefits when you sign up.
If you have an annual income above $88,000, you will pay a higher rate, and programs are available to help reduce costs for those who have a low income.
Yes, you can get $0 Medicare Part C plans
Many Medicare Part C plans have no extra cost on top of what you pay for Part B. That's not a scam. These $0 Part C plans are available because of how funds are transferred behind the scenes.
The public pays into the government's Medicare fund for the health care program. Then, funds are distributed to the private insurance companies that administer Medicare Part C plans as a part of a government contract that has a set rate per enrollee. A $0 plan means that the government distribution is enough to pay for the plan's benefits.
Free Medicare Part C plans are popular, and about 69% of enrollees choose a Part C plan with no premium.
The coverage and benefits will vary for the $0 plans. For example, some plans could have a lower deductible, and others could give you better coverage for dental care.
Some Part C plans provide financial benefits for enrollees and will offer a Medicare Part B premium reduction. With these plans, which are typically called "giveback plans," you won’t pay anything for Part C, and the plan will lower your monthly Part B costs, reducing the total amount you pay for Medicare.
2023 cost of Medicare Part C by state
Medicare plans vary by location, and some states have plans with very different prices than the national average.
State | Cost |
|---|---|
| Alabama | $21 |
| Arizona | $15 |
| Arkansas | $20 |
| California | $17 |
| Colorado | $17 |
Average monthly cost in 2023 for Medicare Part C plans with prescription drug coverage
Medicare Part C plans are cheaper in Nevada, Nebraska, South Carolina and Florida, costing an average of $5 to $12 per month. In these states, a large portion of available plans cost $0, which keeps the average costs low.
Medicare Part C plans are generally more expensive in Maryland, North Dakota, Minnesota and South Dakota, averaging $57 to $72 per month. This is in part due to the high-cost insurance companies in these states such as Johns Hopkins HealthCare in Maryland and Medica in the Dakotas.
What else do you pay for when you have Medicare Part C?
When considering your Medicare expenses, there are two costs to consider in addition to your monthly premium.
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Add-on insurance policies
Coverage for dental, vision or hearing varies. These benefits may be included in a Part C plan, which means you'd have no extra cost. You could also have to pay a fee to add this coverage or buy a stand-alone plan.
A cheaper policy is less likely to include these benefits, and the extra costs can add up. For example, in addition to a $15 Part C plan, you could pay an extra $25 per month for dental coverage and $15 for vision, bringing your total to $55 per month. If you want these coverages, compare the total cost of a cheap policy with add-ons to a more comprehensive policy with a higher price. You may pay less overall by choosing a bundled plan that includes dental and vision coverage.
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Out-of-pocket costs for medical care
Each enrollee will have extra out-of-pocket expenses for medical care including copayment costs for medical treatments and a deductible that must be met before most of the plan’s benefits begin.
These out-of-pocket costs will vary based on the plan details, and comparing out-of-pocket costs is an important part of choosing the best plan for your needs.
You’ll get the best overall deal if you look at the total amount you expect to pay for your Medicare plan and your medical costs. For example, those who have high medical needs may be able to save money overall by selecting a more expensive plan with better coverage. Those who need less medical care can save money by signing up for a cheaper plan and paying more for each doctor's visit or medical service.
What does Medicare Part C cover?
A Medicare Part C plan will cover the same medical services as Original Medicare. That means plans will cover doctors, hospital care and many other types of health services. Coverage includes:
- Inpatient care
- Outpatient care
- Doctors and specialists
- Mental health
- Home health care
- Skilled nursing facilities
- Long-term care
- Lab tests, X-rays and diagnostics
Even though Part C coverage may be similar to Original Medicare, there are key differences that will affect your access to care and how much you pay for medical services.
How to compare benefits and coverage for Medicare Part C
Each Medicare Part C plan has a different level of coverage for medical care and prescriptions. Plans also differ in the extras they include.
Benefits
Even though the same set of services is covered by Medicare Part C and Original Medicare, the level of coverage with Medicare Part C may vary depending on which company and plan you choose.
For example, Original Medicare benefits are standardized, and you’ll usually pay 20% of the cost for doctor services. On the other hand, a Medicare Part C plan will have a specified copayment or coinsurance for each covered service. With one plan, a medical service could cost just $10, and if you have the same medical service with another plan, you could pay 40% of the bill.
Because of this variability, it's important to choose a health plan that has strong coverage for your expected health needs. For example, if you expect to need a joint replacement in the upcoming year, compare plans based on their inpatient hospitalization benefits and access to physical therapy.
Extra coverage
Part C plans often include benefits in addition to what Original Medicare offers. This can include more preventive care, auxiliary health care services and discount programs. As a part of their unified coverage, most plans also include prescription drug coverage, adding in the benefits that would normally be offered through a separate Part D plan.
Medical service | Medicare Part C coverage |
|---|---|
| Prescription drugs | 89% of plans include prescription drug coverage |
| Dental coverage | 97% of plans have the option for dental care, but sometimes it costs extra |
| Vision | 99% of plans provide some level of benefits for eye exams or corrective lenses |
| Hearing | 97% of plans cover hearing exams, and 88% of plans provide some coverage for hearing aids |
| Fitness benefits | 99% of plans provide some fitness discounts or benefits such as a gym membership |
| Chiropractic treatments | All plans cover medically necessary adjustments, and some plans cover routine adjustments |
What are the advantages and disadvantages of Medicare Part C?
The structure and benefits of plans mean that Medicare Part C has both advantages and disadvantages when you’re considering what type of coverage is best for you.
Pros:
- Covers same medical services as Original Medicare
- Usually includes prescription drug coverage
- Often includes extras such as dental or vision coverage
- Plans are cheap or, in some cases, free
- Limited network of providers defined by insurance company
- Variable amount of cost-sharing benefits
- Referrals or preauthorization may be needed for some services
Other parts of Medicare
Best Medicare Part C plans
Medicare Part C plan availability will change from location to location, and several providers only operate in select states or service areas. When choosing a Medicare plan, the first step is to find out what providers and plan options are available to you.
If one of the best-rated Medicare Part C plans is available near you, these picks can help you find a Medicare plan that's a good value. Otherwise, compare cost, coverage and overall rankings to find a plan that works for your medical needs and budget.
How do you sign up for Medicare Part C?
You can sign up or change your Medicare Part C plan during one of the Medicare enrollment periods.
For most people, initial enrollment in Medicare happens around your 65th birthday, starting three months before your birthday month and ending three months after your birthday month.
- Sign up for Original Medicare through the Social Security Administration to get your Medicare card with a unique Medicare number.
- Compare available plans to find the option that’s best for you.
- Enroll in the Medicare Part C plan through a portal like Medicare.gov or directly through the insurance company.
Because plan availability and benefits change each year, review your coverage during the annual open enrollment period. This can help you make sure you’re still getting the best deal for the coverage you need.
Frequently asked questions
How does Medicare Part C work?
Medicare Part C is a bundled insurance plan that can provide coverage for hospital services, medical care, prescription drugs and more. The Medicare plans are administered by a private insurance company rather than directly through the federal government.
Why are some Medicare Part C plans free?
Some Medicare Part C plans are available for $0 because of the behind-the-scenes pricing structures set by the government contracts. You pay into the government's Medicare program with your income taxes, and the government pays the health insurance company that administers the benefits. These "free" plans actually mean that the insurance company gets enough from the government to cover the policy's benefits.
Why do you need Medicare Part C?
Medicare Part C is an optional way that you can combine coverage from Medicare Part A (hospital insurance) and Medicare Part B (medical insurance). Many plans also include prescription drug coverage and other benefits such as dental, vision, fitness and more.
Who is eligible for Medicare Part C?
All those who are eligible for Original Medicare are also eligible for a Medicare Part C (Medicare Advantage) plan. You can join a Medicare Advantage plan during your Initial Enrollment Period (IEP). During Medicare Open Enrollment, you can change your Part C coverage or switch between types of Medicare plans.
Methodology
Medicare Part C cost data and star ratings were sourced from the Centers for Medicare & Medicaid Services (CMS) public use files.
Average costs are based on Medicare Part C plans that include prescription drug coverage. Our analysis excludes employer-sponsored plans, Special Needs Plans, PACE plans, sanctioned plans and Health Care Prepayment Plans (HCPPs). Overall and category averages are based on 2023 plans.
Other sources include Medicare.gov, the Kaiser Family Foundation and the U.S. Department of Health and Human Services (HHS).
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