Medicare Part C 2027: How Medicare Advantage Works

A Part C plan covers everything Medicare Part A and Medicare Part B cover, except hospice, which Original Medicare still pays for. Most plans also include Medicare Part D drug coverage, which is why they are often called MAPD plans.

Many plans may also add benefits Original Medicare does not cover, such as routine dental, vision, hearing and fitness, depending on the plan and area. Not all plans offer all benefits.

• You have both Medicare Part A and Part B
• You live in the plan’s service area
• You are a U.S. citizen or lawfully present in the U.S.
• People with End-Stage Renal Disease can join most plans (since 2021)

• HMO (Health Maintenance Organization): you use the plan’s network except in emergencies and usually need referrals for specialists. Often the lowest premiums.
• PPO (Preferred Provider Organization): you can go out of network at a higher cost, usually without referrals.
• SNP (Special Needs Plan): for people with certain chronic conditions, people in institutions, or people with both Medicare and Medicaid.
• PFFS (Private Fee-for-Service): the plan sets what it pays providers, and you can see any provider who agrees to its terms.
• MSA (Medical Savings Account): a high-deductible plan paired with a bank account the plan deposits money into.

Your actual costs depend on the plan and where you live. Our Medicare Advantage plans 2027 guide covers what is changing, HMO vs PPO and how to compare plans.

Medicare rates Part C plans from one to five stars based on quality and member experience. Higher-rated plans often perform better on preventive care and customer service. If a five-star plan is available in your area, you can switch into it once between December 8 and November 30 of the following year.

• Initial Enrollment Period: when you first get Medicare, around your 65th birthday.
• Annual Enrollment Period: October 15 to December 7, 2026, for coverage starting January 1, 2027.
• Medicare Advantage Open Enrollment Period: January 1 to March 31, 2027, one change if you are already in a Part C plan.
• Special Enrollment Periods: for events such as moving out of your plan’s area or your plan leaving Medicare.

The alternative to Part C is Original Medicare with a Medicare Supplement plan and a stand-alone Part D plan. Medigap usually costs more each month but lets you see any doctor who accepts Medicare with few out-of-pocket costs.