What Is Medicare Part C?

Medicare Part C is the official name for Medicare Advantage. It's not a separate benefit on top of Parts A and B. It's a different way to receive those same benefits, through a private insurance company instead of directly through the federal government. About 54% of Medicare beneficiaries now choose this route.

How Part C Works

When you enroll in a Part C plan, Medicare pays the private insurer a fixed amount per month for your care. The insurer then provides all your Part A (hospital) and Part B (medical) benefits, and usually Part D (prescription drugs) as well. You still pay your Part B premium to Medicare. The Part C plan may charge an additional premium, though 67% of plans in 2026 charge $0 extra.

What Part C Adds

Part C plans must cover everything Original Medicare covers, but they can structure cost-sharing differently (different copays, coinsurance, and deductibles). Most plans add benefits Original Medicare doesn't include: dental, vision, hearing, fitness programs, over-the-counter health product allowances, and transportation to medical appointments. They also must include an annual out-of-pocket maximum, capped at $9,250 in-network for 2026.

Plan Types Under Part C

Most Part C plans are HMOs or PPOs. HMO plans require you to use in-network providers and may need referrals for specialists. PPO plans let you go out of network at a higher cost and don't require referrals. There are also Special Needs Plans (SNPs) designed for people with specific chronic conditions, dual eligibles, or those in certain institutions.

How to Enroll

You can sign up for a Part C plan during your Initial Enrollment Period (around your 65th birthday), during the Annual Enrollment Period (October 15 to December 7), or during the Medicare Advantage Open Enrollment Period (January 1 to March 31). To be eligible, you must have both Part A and Part B and live in the plan's service area.