Medicare Part C premiums vary by plan and location, but most people pay between $0 and $200 per month in 2024

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 monthly premium you pay depends on which plan you choose, where you live, and what the insurance company decides to charge. Some plans have no monthly premium at all — you pay only the Part B premium that goes to Medicare — while others charge $50, $100, or more on top of that.

The premium is not the only cost. You also pay a deductible (usually $0 to $500), copays when you see a doctor or fill a prescription, and coinsurance on some services. The total you spend in a year is capped — in 2024, the maximum out-of-pocket limit ranges from about $4,500 to $8,000 depending on the plan — but you need to know what you are signing up for before you enroll.

Key Takeaways

  • Part C premiums in 2024 range from $0 to over $200 per month, and the amount changes every year based on where you live and which plan you pick.
  • You always pay the Part B premium to Medicare, and then you may pay an additional premium directly to the insurance company offering the Part C plan.
  • Copays, deductibles, and coinsurance are separate from the premium and can add up to thousands of dollars per year depending on how much care you use.
  • The out-of-pocket maximum protects you from unlimited costs, but it varies by plan and is typically between $4,500 and $8,000 annually.
  • Plans available to you and their costs change every year during open enrollment, so comparing options each fall is important even if you are happy with your current plan.

How the premium is split between Medicare and the insurance company

When you enroll in a Part C plan, you are still required to pay the Part B premium to Medicare each month. In 2024, the standard Part B premium is $164.90 per month for most people, though it can be higher if your income is above a certain threshold. This money goes to the federal government, not to your insurance company.

On top of that, the insurance company offering your Part C plan may charge its own monthly premium. This is the amount you see advertised as "$0" or "$49.95" or "$150" — it is what the company charges you directly. Some companies charge nothing because they receive a payment from Medicare for taking on the risk of covering you. Others charge a premium because their plan includes extra benefits like dental or vision coverage, or because they operate in a market where costs are higher.

The total monthly cost to you is the Part B premium plus any additional premium from the insurance company. If a plan shows "$0 premium," you still pay Part B to Medicare — you are just not paying the insurance company anything extra.

What deductibles and copays add on top of the premium

The monthly premium is separate from what you pay when you actually use care. Most Part C plans have an annual deductible — the amount you must pay out of your own pocket before the plan starts to help pay for services. In 2024, deductibles range from $0 to around $500 for medical services, though some plans have no deductible at all.

After you meet the deductible, you pay a copay (a fixed dollar amount like $20 for a doctor visit) or coinsurance (a percentage of the cost, like 20%). These amounts vary widely by plan. A plan with a $0 premium might have higher copays, while a plan with a higher premium might have lower copays. You need to look at the plan's Summary of Benefits to see the exact copay for each type of service — doctor visits, specialist visits, hospital stays, emergency room, urgent care, and prescription drugs.

Prescription drug coverage is built into Part C, so you do not pay a separate Part D premium. However, you pay copays or coinsurance for each prescription, and those costs vary by plan and by drug tier.

The out-of-pocket maximum and how it protects you

Every Part C plan has an out-of-pocket maximum — a yearly limit on how much you will pay for covered services. Once you reach that limit, the plan pays 100% of your covered costs for the rest of the year. In 2024, the out-of-pocket maximum ranges from about $4,500 to $8,000 depending on the plan, though some plans set it lower.

The out-of-pocket maximum includes deductibles, copays, and coinsurance, but it does not include the monthly premium you pay to the insurance company. It also does not include costs for services the plan does not cover, such as routine dental or vision care (unless your plan includes those as extra benefits), or care from out-of-network providers if you do not have an emergency.

This cap is important because it means you have a predictable worst-case scenario. If you know your plan's out-of-pocket maximum is $6,000, you know that in the worst year, you will not pay more than $6,000 plus your monthly premiums. Original Medicare has no out-of-pocket maximum, which is why some people prefer Part C for the financial protection.

How location and plan choice affect what you pay

The same insurance company may offer different Part C plans in different counties, and the premiums and cost-sharing can differ significantly. A plan that costs $0 per month in one county might cost $50 in another. This is because insurance companies set their rates based on local healthcare costs, competition, and the health status of people who enroll.

You can only enroll in plans available in your ZIP code. If you move, the plans available to you may change, and you may want to switch plans during the Annual Enrollment Period (October 15 to December 7 each year). Even if you stay in the same place, new plans may become available each year, and existing plans may change their premiums and benefits.

The best way to compare what you will actually pay is to use the Medicare Plan Finder tool on Medicare.gov. You enter your ZIP code, the medications you take, and the doctors you see, and the tool shows you the estimated annual cost for each plan available to you — including premiums, copays, and deductibles based on your specific situation.

Income-related premiums and extra help programs

If your income is above a certain level, you may pay a higher Part B premium, which affects your total Part C cost. In 2024, if your modified adjusted gross income is above $97,000 (single) or $194,000 (married), your Part B premium increases. This is called the Income-Related Monthly Adjustment Amount, or IRMAA.

If your income is low, you may be able to get help paying premiums and cost-sharing through Medicaid or the Medicare Savings Program. These programs vary by state, but they can cover your Part B premium, deductibles, and copays. You explore through your state Medicaid office, not through Medicare directly.

When premiums and benefits change each year

Part C plans announce their premiums and benefits for the next year in September, and the changes take effect January 1. During the Annual Enrollment Period (October 15 to December 7), you can switch to a different plan or drop Part C and go back to Original Medicare. If you do not make a change during this window, you stay in your current plan.

Even if you are happy with your plan, it is worth reviewing your options each fall. A plan you liked last year might raise its premium or change its copays. A new plan might enter your market with lower costs. The Medicare Plan Finder tool lets you compare your current plan side-by-side with other options available to you, so you can see whether switching would save you money.

Frequently Asked Questions

Is there a Part C plan with no premium and no copays?

Some plans have $0 monthly premium and $0 copays for certain services like preventive care or primary care visits. However, no plan has zero cost for everything. You will have copays for specialists, emergency room, or hospital stays, and you will pay for prescription drugs. The trade-off is that plans with lower premiums often have higher copays.

What happens if I cannot afford the copays in my Part C plan?

If your income is low, you may be able to get help through your state's Medicare Savings Program or Medicaid, which can cover copays and deductibles. You explore through your state Medicaid office. If you are not low-income, you can switch to a different Part C plan during the Annual Enrollment Period, or switch to Original Medicare if you want more flexibility in choosing providers.

Do I have to stay in the same Part C plan every year?

No. You can change plans or drop Part C during the Annual Enrollment Period each October 15 to December 7. If you miss this window, you are locked into your plan for the year unless you have a may have access to life event like moving, losing other coverage, or a change in income.

Why do two Part C plans in my area have different premiums if they are both from the same company?

Insurance companies often offer multiple Part C plans in the same area with different benefit structures and costs. One plan might have a $0 premium and higher copays, while another has a higher premium and lower copays. They are designed to appeal to different people based on how much healthcare they expect to use.

Is the Part B premium included in the out-of-pocket maximum?

No. The out-of-pocket maximum covers deductibles, copays, and coinsurance for covered services, but not the monthly premium you pay to Medicare for Part B or to the insurance company for Part C. The premium is a separate cost that does not count toward the maximum.