Part C costs vary by plan and region, but most people pay a monthly premium, and many pay nothing at all

Part C (also called Medicare Advantage) is an alternative to Original Medicare. Instead of paying separately for Part A (hospital) and Part B (medical), you enroll in a private insurance plan that covers both. Your costs depend on which plan you choose, where you live, and your income.

Most Part C plans charge a monthly premium on top of your Part B premium. Some plans charge zero premium — you pay only your Part B premium to Medicare, then the plan's copays and deductibles when you use care. Others charge $50 to $200+ per month. The trade-off is usually lower premiums for higher copays, or higher premiums for lower copays.

Part C plans also have an out-of-pocket maximum — a yearly cap on what you pay for covered services. Once you hit that limit, the plan pays 100% of covered costs for the rest of the year. Original Medicare has no such cap.

Key Takeaways

  • Part C premiums range from $0 to $200+ per month depending on the plan, and you always pay your Part B premium to Medicare on top of that.
  • Every Part C plan has an out-of-pocket maximum (typically $6,700 to $7,500 per year) that limits your total yearly costs for covered services.
  • Your actual costs depend on the plan's copays, coinsurance, and deductibles — not just the monthly premium.
  • If your income is below certain thresholds, you may receive subsidies that lower your Part C premium and out-of-pocket costs.
  • You can change plans during the Annual Enrollment Period (October 15 to December 7 each year) to find one that fits your budget and health needs.

How Part C premiums are set

Insurance companies offering Part C plans bid with Medicare each year to set their premiums. Plans in the same region can have very different prices because each company decides what to charge. A plan in one county might cost $45 per month, while a similar plan in the next county costs $120.

Plans also vary by what they cover beyond the Medicare basics. Some include dental, vision, or hearing coverage — and those plans often charge higher premiums. Others focus on low premiums and higher copays. There is no single "Part C cost" — you have to compare the actual plans available in your zip code.

Your Part B premium (currently $164.90 per month for most people in 2024, though this changes yearly) is separate from your Part C premium. You pay Part B to Medicare no matter which Part C plan you choose.

Out-of-pocket maximums and how they work

Every Part C plan must have an out-of-pocket maximum set by Medicare. In 2024, that maximum ranges from about $6,700 to $7,500 per year, depending on the plan. This is the most you will pay in copays, coinsurance, and deductibles combined. Once you reach it, the plan covers 100% of your covered services for the rest of that calendar year.

This is different from Original Medicare, which has no yearly limit. If you have expensive health needs, an out-of-pocket maximum can protect you from unlimited costs. If you are generally healthy and use little care, you might never reach it — and you will have paid premiums for protection you did not use.

The out-of-pocket maximum does not include your monthly premiums. Those are separate costs you pay every month regardless of how much care you use.

Copays and deductibles in Part C plans

Part C plans set their own copays and deductibles within Medicare rules. A copay is a fixed amount you pay for a service — for example, $25 for a doctor visit or $300 for an emergency room visit. Coinsurance is a percentage of the cost you pay after you meet your deductible.

Plans with low or zero premiums often have higher copays. Plans with higher premiums often have lower copays. You might pay $0 premium but $50 per doctor visit, or $100 premium but $10 per doctor visit. The total cost over a year depends on how often you see doctors and which services you use.

Prescription drug coverage is built into Part C plans (unlike Original Medicare, where you buy it separately). The plan's formulary — its list of covered drugs — and your copays for those drugs vary by plan. If you take expensive medications, comparing drug costs across plans is important.

Income-based subsidies that lower your costs

If your income is below 200% to 300% of the federal poverty level (depending on your state), you may receive Extra Help, a program that lowers your Part C premium and out-of-pocket costs. Extra Help is run by Social Security and the Centers for Medicare & Medicaid Services (CMS).

To learn whether you may have access to, contact Social Security at 1-800-772-1213 or visit ssa.gov. You can also ask your local Area Agency on Aging — they can help you understand whether you meet the income and resource limits. If you may have access to, the subsidy is applied automatically; you do not have to pay and then get reimbursed.

Some states also offer additional programs for low-income Medicare beneficiaries. Your state Medicaid office or local aging agency can tell you what is available where you live.

Comparing costs across different Part C plans

Medicare publishes a plan comparison tool at Medicare.gov where you can enter your zip code and see every Part C plan available to you, along with premiums, copays, deductibles, and drug coverage. You can filter by premium cost, out-of-pocket maximum, or whether the plan includes dental or vision.

The tool shows you the estimated yearly cost for each plan based on your current medications and doctors (if you enter that information). This estimate helps you see the real cost difference, not just the premium. A plan with a $0 premium might cost you $3,000 more per year in copays than a plan with a $100 premium, depending on your health needs.

You can also call 1-800-MEDICARE to speak with a counselor who can walk you through plan options and costs. Many Area Agencies on Aging also offer free counseling during enrollment season.

When you can change plans and what it costs

You can change Part C plans once per year during the Annual Enrollment Period, which runs from October 15 to December 7. Changes take effect January 1. If you miss this window, you generally cannot switch until the next year, unless you have a may have access to life event (such as moving, losing employer coverage, or becoming may be able to access for Medicaid).

Changing plans is free — there is no penalty or fee. You straightforward enroll in a new plan, and your old plan coverage ends on December 31. If you want to switch back to Original Medicare, you can do that during this period too, though you will need to enroll in a separate Part D (prescription drug) plan if you want drug coverage.

Some people switch plans every year to find the lowest cost option. Others stay with the same plan for years. The key is checking your options each October to see whether a different plan would save you money or better match your health needs.

Frequently Asked Questions

Do I have to pay Part B premium if I choose Part C?

Yes. Part B premium is separate from Part C. You pay Part B to Medicare every month, and then you pay your Part C plan's premium (if it has one) on top of that. Part C replaces your need for Part A and Part B coverage, but you still pay the Part B premium.

What happens if I cannot afford my Part C plan's copays?

If your income is low, you may may have access to for Extra Help, which lowers copays and premiums. Contact Social Security at 1-800-772-1213 to learn about income limits. You can also ask your plan about hardship programs or payment plans, though these vary by plan.

Can I switch to Original Medicare if I decide Part C is too expensive?

Yes, during the Annual Enrollment Period (October 15 to December 7). You can switch to Original Medicare at any time during this window. If you do, you will need to enroll in a separate Part D plan for prescription drug coverage, which has its own premium and copays.

Are there Part C plans that cost nothing per month?

Yes, many plans charge $0 premium. However, they typically have higher copays and deductibles than plans with higher premiums. Compare the total yearly cost — premium plus copays — not just the monthly premium.

How do I know what my actual costs will be with a Part C plan?

Use the Medicare plan comparison tool at Medicare.gov. Enter your zip code, current medications, and doctors. The tool estimates your yearly costs for each plan based on your specific health needs, not just the premium.