Part C plans
Medicare Advantage
Compare Medicare Advantage plans by provider networks, prescriptions, plan type, prior authorization rules, and total yearly costs.
How Medicare Advantage works
One private plan organizes your Medicare benefits.
Medicare Advantage, also called Part C, is offered by Medicare-approved private insurers. You remain in Medicare and continue paying your Part B premium, while the plan sets the network, cost-sharing, and coverage rules you use.
Start with access, not extras
A strong plan fits the care you actually use.
- 01Confirm doctors and hospitals
Check the exact plan network, medical group, and whether each provider is accepting the plan.
- 02Run every prescription
Compare formulary status, tier, pharmacy pricing, and coverage rules.
- 03Estimate a full year
Look beyond premium to copays, coinsurance, and the medical out-of-pocket limit.
- 04Then review extra benefits
Dental, vision, hearing, fitness, and allowance benefits vary by plan and service area.
Common plan types
HMO and PPO plans handle access differently.
This is a practical starting point, not a substitute for the plan evidence of coverage. Exact networks, referrals, drug coverage, and costs vary by plan and county.
| Compare | HMOHealth Maintenance Organization | PPOPreferred Provider Organization |
|---|---|---|
| Provider network | You generally use in-network providers, except for emergency, urgent care, and out-of-area dialysis. | You can generally use out-of-network providers that accept the plan, usually at a higher cost. |
| Primary care doctor | Usually required. | Generally not required. |
| Specialist referrals | Usually required. | Generally not required. |
| Prescription coverage | Usually included. If you want Part D, it generally must be through the HMO. | Usually included. If you want Part D, it generally must be through the PPO. |
Prior authorization: Medicare Advantage plans typically require plan approval before certain services or supplies are covered.
Build the full cost picture
A low premium does not describe the whole plan.
Compare the costs you pay every month, the costs you pay when care is used, and the plan limit that caps your spending for covered Part A and Part B services.
Compare plan types at Medicare.govPart B premiumYou continue paying it.
Plan premiumMay be zero or more.
Costs when care is usedCopays, coinsurance, and deductibles.
Annual medical limitThe plan caps covered Part A and Part B out-of-pocket costs.
Official resources
Verify plan rules before enrolling.
Local Medicare guidance
Meet David Keum.
Licensed Medicare advisor CA License #4005450
As an independent insurance agency, Skyline Benefit helps compare Medicare Advantage plan networks, prescriptions, costs, and plan rules with clear, personal guidance.
From our clients
Trusted Medicare guidance from a local team.
Meet our licensed advisors or read client feedback on Google while the live review feed is unavailable.
FAQ
Frequently asked Medicare questions
Browse all Medicare FAQsCan I keep my current doctors?
Only if they are in the plan network and accepting that plan. We verify provider participation as part of the review.
Do Medicare Advantage plans include drug coverage?
Most do, but not all. We review your medications and pharmacy choices against the exact plan formulary.
Are zero-premium plans free?
No. You may still pay Part B premiums, copays, coinsurance, drug costs, and other plan cost-sharing.
What is a Medicare Advantage maximum out-of-pocket limit?
It is the plan limit on what you pay during the year for covered Part A and Part B services. Prescription drug costs follow separate Part D rules and do not count toward that medical limit.
Personal Medicare guidance
Ready to compare plans around your needs?
Bring your doctors, prescriptions, preferred pharmacies, and current coverage. We will help organize the details and explain the tradeoffs.
Skyline Benefit is an independent insurance agency and is not connected with or endorsed by the U.S. government or the federal Medicare program.
We do not offer every plan available in your area. The organizations and number of plans we represent vary by location and eligibility. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.