Medicare Advantage (Part C) plan costs (2025)

Table of Contents

What you pay for your Medicare Advantage plan can vary widely What is my cost share with my Medicare Advantage plan? Monthly premium Annual deductible Copay Coinsurance Out-of-pocket maximum Are there other Medicare Advantage costs to consider? Added benefits and services See more Medicare Advantage plan benefits from UnitedHealthcare Prescription drug coverage Network of doctors and hospitals Total out-of-pocket costs How to manage your Medicare Advantage plan costs Can I get help paying for my Medicare Advantage plan? Features and benefits of Special Needsplans Special Needs plan types How to manage your Medicare Advantage plan costs Additional Medicare Advantage plan resources Need more information? Do you qualify for both Medicare and Medicaid? Chat with UnitedHealthcare Call UnitedHealthcare Find a plan Meet with us Make an appointment with a licensed insurance agent in your area. Already a member?

What you pay for your Medicare Advantage plan can vary widely

It depends on the type of plan, the coverage you get and other factors. Make sure you consider your needs and all costs before you make a choice.

What is my cost share with my Medicare Advantage plan?

Medicare Advantage (Part C) plans often have a low or $0 monthly premium. That sounds like a good deal when you’re on a budget. However, you'll still be responsible for a number of expenses. Make sure you understand what the total cost could be and how it relates to the coverage you receive.

Monthly premium

A monthly premium is the fee you pay to the plan in exchange for coverage. Each Medicare Advantage (Part C) plan has a set monthly premium. Some plans have a low or even $0 monthlypremium.

Annual deductible

An annual deductible is the amount you pay out-of-pocket for your health care before your plan begins to pay. It's a pre-set, fixed cost. Most Medicare Advantage plans have a separate medical and prescription drugdeductible.

Copay

A copayment (also known as a copay) is a kind of cost sharing. You pay a predictable, pre-set amount for a covered medical service. For example, some plans might charge a $30 copay every time you see yourdoctor.

Coinsurance

Coinsurance is a percentage of the total cost you pay for a covered medical service. Your plan pays the remaining amount owed. For example, your plan might pay 75% and your share would be25%.

Out-of-pocket maximum

Medicare Advantage plans have a limit on how much you have to pay every year. Once you reach the annual limit — known as an out-of-pocket maximum — you pay nothing more for covered expenses for the rest of the planyear.

Learn how to compare Medicare Advantage plan costs

Are there other Medicare Advantage costs to consider?

While extra coverage may mean an additional cost up front, it could save you money in the long run. When comparing plans, consider the following items:

Added benefits and services

Do you need extra coverage like dental, hearing, or vision care? Some plans include extra benefits for no extra cost. Some offer them as plan "riders" for an additional monthly fee. Look for a plan that meets your budget and helps you save money on the benefits and services you need.

See more Medicare Advantage plan benefits from UnitedHealthcare

Prescription drug coverage

Most Medicare Advantage plans include prescription drug coverage. This is known as an MAPD plan. In fact, the monthly premium for an MAPD plan is often less than a prescription drug plan alone. Check the plan's drug list (formulary) to make sure your prescriptions are covered and find out how much they'll cost.

Estimate your prescription drug costs

Network of doctors and hospitals

Many Medicare Advantage plans have a network of covered doctors and hospitals. Depending on the plan, you may have more or less flexibility to see your own doctor. Generally, you'll pay less out-of-pocket if you go to a doctor that's in your plan's network.

Compare Medicare Advantage plans

Total out-of-pocket costs

Just because a Medicare Advantage plan has a low premium doesn't mean it's the most cost-effective plan for you. Weigh each plan's costs and benefits according to your own needs.

See Medicare Advantage plans where you live

How to manage your Medicare Advantage plan costs

Each Medicare Advantage plan sets its own specific costs. When you compare them, consider the premium, deductible, copay and coinsurance to get an idea of your total out-of-pocket expenses.

Can I get help paying for my Medicare Advantage plan?

If you want the added benefits of a Medicare Advantage plan, but need help covering the costs, there may be help for you. Medicare Special Needs plans (SNPs) are Medicare Advantage plans for people who are eligible for Medicare and have certain financial or healthcare needs.

Features and benefits of Special Needsplans

Eligibility for a SNP is based on qualifications set by federal law. Each SNP offers benefits that go beyond Original Medicare. SNPs offer the following:

Benefits specific to a condition, disease or living situation
Always include prescription drug coverage
May offer additional benefits, similar to Medicare Advantage plans

Special Needs plan types

There are different types of Special Needs plans. All offer specialized benefits:

Dual-Eligible Special Needs plans (D-SNPs)
You have both Medicare and Medicaid (called "dualeligible").
Chronic Special Needs plans (C-SNPs)
You live with severe or disabling chronicconditions.
Institutional Special Needs plans (I-SNPs)
You live in a skilled nursing facility.

A person who lives in a contracted assisted living facility and needs the same kind of care as those who live in a skilled nursing facility may qualify for an Institutional-Equivalent Special Needs plan (IE-SNP). This is a special type of I-SNP.

Learn more about dual eligibility and Dual Special Needs plans

How to manage your Medicare Advantage plan costs

Each Medicare Advantage plan sets its own specific costs. To compare them, start by looking for plan benefits that meet your needs. Consider the premium, deductible, copay and coinsurance to get an idea of your total out-of-pocket expenses. Staying in-network can often help you save. Also, check to see if you qualify for discount programs.

Read about Medicare Advantage plans