Medicare Part C costs vary by plan and location, but most seniors pay a monthly premium between $0 and $200, plus out-of-pocket costs when you use care
Medicare Part C, also called Medicare Advantage, is an alternative way to get your Part A and Part B coverage through a private insurance company instead of Original Medicare. The total cost depends on three things: the monthly premium you pay the insurance company, the deductible you pay before coverage starts, and the copays or coinsurance you pay when you see a doctor or get treatment.
Unlike Original Medicare, where costs are set nationally, Part C plans are priced by the insurance company offering them. This means two people in the same town might pay different amounts, and plans available in one county may not exist in another. You will see the exact costs for every plan available to you during Open Enrollment, which runs from October 15 to December 7 each year.
Key Takeaways
- Part C monthly premiums range from $0 to over $200 depending on the plan and your location, and you must also have Part B to enroll.
- You pay a deductible before the plan starts covering care, and then copays or coinsurance each time you use a service — these amounts vary by plan.
- Plans with $0 premiums exist but usually have higher deductibles and copays, so the lowest premium is not always the lowest total cost.
- Your costs can change every year, so you should review your plan's pricing during Open Enrollment even if you were happy with it last year.
- You can see the exact premium, deductible, and copay amounts for every plan in your area on Medicare.gov before you choose.
The three parts of what you pay
Every Part C plan charges you in three ways. The monthly premium is what you pay the insurance company to have the plan. The deductible is the amount you pay out of your own pocket before the plan starts to cover your care — some plans have no deductible. The copay or coinsurance is what you pay each time you use a service, like a doctor visit or hospital stay.
A plan with a $0 premium might sound free, but it usually means the deductible is higher or the copays are larger. For example, one plan might charge $50 a month with a $500 deductible and $20 copays, while another charges $0 a month with a $1,500 deductible and $35 copays. The second plan is not cheaper unless you rarely see a doctor. Medicare.gov lets you enter your medications and doctors to estimate your total out-of-pocket cost for each plan, which is more useful than looking at the premium alone.
How premiums are set
Insurance companies decide what to charge for Part C based on the cost of care in your area, the age and health of the people who enroll, and how much profit they want to make. Medicare pays the insurance company a set amount per person each month, and the company keeps the difference between what Medicare pays and what the plan costs to run. If a plan is very popular and attracts healthy people, the company might lower the premium. If a plan is unpopular or attracts sicker people, the premium might go up.
This is why the same plan can cost different amounts in different counties, and why plans change their prices every year. A plan that cost $45 a month last year might cost $65 this year, or a new plan might appear in your area that costs less. You cannot assume your costs will stay the same.
What happens if you also take prescription drugs
Many Part C plans include prescription drug coverage, which is called Part D when it is separate. If your plan includes drug coverage, you pay a copay or coinsurance for each prescription — usually $5 to $50 per medication depending on the drug and the plan. Some plans have a deductible just for drugs, separate from the medical deductible.
If your plan does not include drug coverage, you must enroll in a standalone Part D plan or pay a penalty later. The Part D premium is separate from your Part C premium. You can see which medications are covered by each plan on Medicare.gov before you choose, which matters if you take expensive or specialty drugs.
Extra costs that Part C does not cover
Part C covers the same services as Original Medicare — hospital care, doctor visits, lab work, imaging, and preventive care. But it does not cover everything. You will still pay for dental work, vision care, hearing aids, and long-term care in a nursing home. Some Part C plans offer extra benefits like dental or vision coverage, but these are add-ons and may have their own copays or limits.
You are also responsible for the Part B premium, which you pay to Medicare directly. As of 2024, the standard Part B premium is $164.90 a month, but it is higher if your income is above a certain level. This premium is separate from your Part C premium and is not included in the Part C cost.
How to compare costs across plans
The best way to see what you will actually pay is to use the Medicare Plan Finder tool on Medicare.gov. You enter your zip code, the doctors you see, the hospitals you use, and the medications you take. The tool then shows you every Part C plan available in your area and estimates your total out-of-pocket cost for the year, including premiums, deductibles, copays, and drug costs.
This estimate is more useful than comparing premiums alone because it accounts for how you actually use care. If you see a cardiologist four times a year, a plan with a $20 copay per visit costs you $80 a year just for that, while a plan with a $40 copay costs $160. The Plan Finder adds this up for you across all your doctors and medications.
You can also call 1-800-MEDICARE to speak with someone who can walk you through the plans available to you. They cannot recommend a specific plan, but they can explain what each plan covers and costs.
When your costs can change
Part C costs change every year. Insurance companies submit new rates to Medicare in the spring, and those rates take effect on January 1. During Open Enrollment in October and November, you can see the new costs for your current plan and compare them to other plans. If your plan's costs went up significantly or you want to switch to a cheaper plan, you can make that change during Open Enrollment and it will start on January 1.
If you miss Open Enrollment, you are locked into your plan for the rest of the year unless you have a may have access to life event, like losing other health coverage, moving to a new county, or getting married. Some people also may have access to for Special Enrollment Periods if they are new to Medicare or if their plan is leaving the market.
Frequently Asked Questions
Can I switch Part C plans if my costs go up?
Yes, but only during Open Enrollment from October 15 to December 7 each year. If you miss this window, you are stuck with your plan unless you have a may have access to life event like moving or losing other coverage. Check your plan's costs every October so you do not miss the chance to switch.
Do I have to pay the Part B premium if I have Part C?
Yes. Part C is a way to get Part A and Part B coverage through a private company, but you still pay the Part B premium to Medicare. Your Part C premium is separate and on top of that. If you do not pay Part B, you cannot enroll in Part C.
What if a Part C plan costs $0 a month?
A $0 premium plan exists but usually has higher deductibles and copays. Use the Plan Finder tool to estimate your total yearly cost, including deductibles and copays, not just the premium. A plan with a $0 premium might cost you more overall if you see doctors frequently.
Are there any Part C plans that cover dental or vision?
Some plans include dental or vision benefits, but not all. These are add-on benefits and vary widely — one plan might cover one cleaning a year, while another covers two. Check the plan details on Medicare.gov to see what is included and what you would pay.
What if I cannot afford the Part C premium?
If your income is low, you may may have access to for help paying Part B and Part C premiums through a program called the Low-Income Subsidy or through your state's Medicaid program. Contact your local Medicaid office or call 1-800-MEDICARE to learn what programs may be available based on your income.