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Written byJanet Berry-Johnson
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8+ years writing about insurance, taxes, and personal finance
Certified public accountant
Janet applies her experience in personal finance, taxes, and accounting to make complex financial topics accessible. Her byline has appeared on numerous web media.
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Edited byAshley Cox
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7+ years in content creation and management
5+ years in insurance and personal finance content
Ashley is a seasoned personal finance editor who’s produced a variety of digital content, including insurance, credit cards, mortgages, and consumer lending products.
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Updated June 24, 2024
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Table of contents
Medicare Part C, also known as Medicare Advantage, is an alternative to Original Medicare coverage. Private health insurance companies offer these plans, and they include Original Medicare Part A (hospital insurance) and Part B (medical insurance). They also typically include additional benefits, like vision, dental, and Part D prescription drug coverage.
The cost of Medicare Part C can vary widely based on factors like plan type, location, and coverage. Here’s what you should know about the costs of this coverage and what to consider when choosing a plan.
The importance of Medicare Part C in healthcare
For many people, Medicare Part C is essential to their medical care. It provides all-in-one coverage that can include additional benefits not covered by an Original Medicare health plan, such as vision, dental, prescription drugs, hearing, and even health and wellness programs.[1]
This added value brings greater convenience by reducing the need for multiple health insurance plans. For families, Medicare Part C offers peace of mind knowing their loved ones can access a wide range of essential healthcare services with predictable out-of-pocket expenses.
Understanding the cost of Medicare Part C
The cost of Medicare Part C varies depending on the type of plan you choose, your location, and the coverage options you select.
On average, Medicare Part C premiums range from $0–$200 per month, according to the National Council on Aging.[2]
Good to Know
Some Medicare Advantage plans may have higher premiums for more expansive coverage. But besides the monthly premium, you should also consider other costs, like copayments, co-insurance, and deductibles. For example, a plan might have low premiums but higher out-of-pocket service costs.
Breakdown of Medicare Part C costs
Understanding the various cost components that affect your Medicare Part C premiums helps you make a more informed decision when choosing a policy. Here’s what you need to know.
Monthly premiums: Your premium is the amount you pay each month for your Medicare Part C plan. Premiums vary depending on the plan and the level of coverage provided.
Deductibles: Your deductible is the amount you’ll pay out of pocket each year before your plan begins to pay for covered services. Not all Medicare Part C plans have deductibles, but for those that do, the amount can vary. Some plans have separate deductibles for medical services and prescription drugs.
Copays/co-insurance: After meeting your deductible, you may need to pay a copay or co-insurance for services. A copay is a fixed amount you pay for a specific service. For example, you might have to pay $20 for each doctor visit. Co-insurance is a percentage of the cost of the service. For example, you may have to pay 20% of the cost of a specialist visit. These amounts can vary based on the plan and type of service.
Out-of-pocket maximums: All Medicare Advantage plans have an out-of-pocket limit on spending. For 2024, that annual limit can’t be more than $8,850, although prescription drug costs don’t count toward that yearly limit.
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Read More: The 10 Best & Worst Medicare Advantage Plans
How income affects Medicare Part C costs
Although private companies — not the federal government — issue Medicare Part C plans, your income still influences the cost of these plans.
The key factor here is your modified adjusted gross income (MAGI), which is the adjusted gross income shown on your federal income tax return plus any untaxed foreign income, nontaxable Social Security benefits, and tax-exempt interest.
If your MAGI is above a certain threshold, you’ll have to pay an income-related monthly adjustment amount for Medicare Part B and Part D.[3] For 2024, those thresholds are:
Tax-Filing Status ▲▼ | Modified Adjusted Gross Income ▲▼ |
|---|---|
| Single/married filing separately/head of household | $103,000 |
| Married filing jointly | $206,000 |
Although this surcharge doesn’t directly apply to Part C plans, the higher Part B and Part D premiums can affect your total Medicare premiums.
What to know about Medicare Part C for low-income patients
Medicare Part C can be helpful for low-income seniors due to its potential cost-saving benefits and additional coverage.
You might qualify for programs like Medicaid or a Medicare Savings Program (MSP), which can help cover Medicare costs, including premiums, deductibles, and copays. The Extra Help program also assists with prescription drug deductibles and copays under Medicare Part D.
So even though Medicare Part C is optional, it might help you reduce your healthcare expenses while gaining access to more comprehensive coverage.
How location affects Medicare Part C costs
While Original Medicare has a set standard for costs and coverage nationwide, your location affects your Medicare Part C costs. Private insurance companies offer these plans, so the available plans and policy options can vary from state to state and even city to city.[4]
For example, big cities may have more plan options than rural areas. Local healthcare costs and provider networks also influence insurance premiums, deductibles, and copays.
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See Also: Medigap vs. Medicare Advantage: Which Plan Is Best for You?
Additional costs of Medicare Part C
Aside from the basic components of Medicare Part C, you might encounter a few additional costs:
Prescription drug costs
Most Medicare Advantage plans include prescription drug coverage, but you may have to pay a separate deductible for your medications. The costs of your prescriptions can also differ from plan to plan, depending on what’s on the plan’s list of covered drugs, or its “formulary.”[5]
Extra services
Medicare Part C plans often include extra services not covered by Original Medicare, such as dental, vision, hearing, and wellness programs. While these services add value, they also come with additional costs, such as higher premiums or specific copays for each service.
Specialist visits
If you need to see a specialist, you may have to pay a higher copay or co-insurance compared to visits with your primary care physician. The cost can vary depending on whether the specialist is within your plan’s network.
Monthly Part B premium
You must pay a separate Medicare Part B premium even if you enroll in a Medicare Part C plan.
Tips for reducing Medicare Part C costs
A few strategies can help you lower your Medicare Part C costs:
Look into subsidy programs and financial assistance. Low-income Medicare beneficiaries may qualify for Medicaid, MSPs, and Extra Help. These programs assist with premiums, deductibles, and copays, lowering out-of-pocket costs.
Compare Medicare Part C plans for cost efficiency. Take time to compare different Medicare Advantage plans. Don’t just look for the lowest premium — compare information like deductibles, copays, and out-of-pocket maximums. Consider plans offering services you use regularly to avoid paying for extra benefits you don’t need.
Choose in-network providers. Using in-network doctors and hospitals can save money, as out-of-network services typically cost more.
How much is Medicare Part C FAQs
Check out this additional information about Medicare Part C to help you understand your total costs.
What is the average cost of a Medicare Part C plan?
The average premium for Medicare Part C ranges from $0–$200 per month, depending on the insurance company, coverages, and benefits offered.
Are there any additional costs involved in Medicare Part C apart from the monthly premium?
Yes. Additional costs include your annual deductible, copays, and co-insurance, which vary by plan and the services you use. But all Medicare Advantage plans have an out-of-pocket maximum.
Can the cost of Medicare Part C vary by location or service utilized?
Yes. The cost of Medicare Part C varied by location due to regional pricing differences and the availability of local healthcare providers and networks.
Do Medicare Part C costs change annually?
It’s likely. Your Medicare Part C costs can change each year. You may have a new premium and deductible, and your copay and co-insurance amounts can change each year as well. It’s important to review your plan each year during the open enrollment period.
How does the cost of Medicare Part C compare to other Medicare plans?
Medicare Part C can be more cost-effective than Original Medicare with Medicare supplement insurance because it bundles benefits and potentially lowers your out-of-pocket costs. But your costs will vary depending on your individual health needs and plan specifics.
Sources
- Medicare.gov. "Understanding Medicare Advantage Plans."
- National Council on Aging. "How Much Does Medicare Part C Cost?."
- Social Security Administration. "Premiums: Rules for Higher-Income Beneficiaries."
- Medicare.gov. "Your health plan options."
- Medicare.gov. "Costs for Medicare drug coverage."
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Janet Berry-Johnson
Janet Berry-Johnson, CPA is a freelance writer with a background in accounting and income tax planning and preparation. She's passionate about making complicated financial topics accessible to readers. She lives in Omaha, Nebraska with her husband and son and their rescue dog, Dexter. Visit her website at www.jberryjohnson.com.
Janet has been a contributor at Insurify since October 2022.
7+ years in content creation and management
5+ years in insurance and personal finance content
Ashley is a seasoned personal finance editor who’s produced a variety of digital content, including insurance, credit cards, mortgages, and consumer lending products.
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