Medicare Advantage, also known as Medicare Part C, is a bundled alternative to Original Medicare that's offered by private insurance companies. It includes Medicare Part A and Part B, usually prescription drug coverage (Medicare Part D) and often additional benefits, which may include some coverage for dental and hearing.
Medicare Advantage plans with a $0 monthly premium are widely available. Even plans that do charge a premium only charge an average of about $42 per month in 2026, according to NerdWallet’s analysis of Centers for Medicare & Medicaid Services (CMS) data.
It sounds like a screaming deal to get an all-in-one bundle for as little as $0, but that’s not the full picture. You’ll still have to pay your Medicare Part B premium. And to get a sense of how much Medicare Advantage truly costs, you need to look beyond the initial price tag and ask: What does Medicare Advantage cost when I actually use it?
So let’s talk about both: What you pay each month, and what you pay when you need medical care.
» MORE: Best Medicare Advantage plans
What you'll pay on Medicare Advantage at a glance
Medicare Advantage premium: $0 for most plans. Plans with a monthly premium charge an average of $42 per month in 2026.
Medicare Part B premium: $202.90 per month in 2026. Some insurers offer “Giveback” plans that cover part of it, but most people pay the full amount.
Prescription drug coverage: No extra premium. Most Medicare Advantage plans include prescription drug coverage.
When you get care: Deductibles, copays and coinsurance. These out-of-pocket costs can add up quickly.
Your maximum: No more than $9,250 in 2026 for in-network care. This is the most a Medicare Advantage plan can make you pay out of pocket for in-network care in a year. Many plans set an even lower limit.
Compare Medicare Advantage plans
Insurance company | NerdWallet rating | $0 plan availability | Members in high-quality plans | Member experience |
|---|---|---|---|---|
52% (Below average) | Medium (50% to 84%) | 3.74 (Average) | ||
66% (Average) | Low (49% or less) | 3.82 (Above average) | ||
60% (Average) | Medium (50% to 84%) | 3.89 (Above average) | ||
77% (Above average) | Medium (50% to 84%) | 3.96 (Above average) |
Your monthly costs on Medicare Advantage
Let’s start with a breakdown of how Medicare Advantage costs hit your budget every month.
Most Medicare Advantage plans don’t charge a monthly premium. Roughly two-thirds of Medicare Advantage plans (67%) have a $0 premium in 2026, according to KFF, a health policy nonprofit.
The $0-premium plans aren’t available everywhere, so you might not be able to find one where you live. But even plans that do charge a premium tend to be relatively affordable. On average, they charge about $42 per month in 2026 according to our analysis of CMS data.
Medicare Part A is free for most people. Usually, you get Part A for free if you or a spouse worked and paid Medicare taxes for at least 10 years. If you don’t qualify for premium-free Part A, you can buy it for $311 or $565 per month.
Medicare Part B comes with a premium that you have to pay, even if you’re on Medicare Advantage. It’s $202.90 per month in 2026, and it can change each year.
Some Medicare Advantage plans will pay for a portion of your Part B premium, a perk often called a “Giveback.” But most plans don’t offer this benefit, and the amount varies a lot. Some plans give back over $100 a month, while others give back less than $10, according to KFF.
» MORE: How much does Medicare cost?
Prescription drug coverage: Included
Prescription drug coverage, known as Medicare Part D, is included in the vast majority of Medicare Advantage plans. But included doesn’t mean free. You’ll still face the out-of-pocket costs discussed below whenever you need prescription medication.
A note on IRMAA for high earners
Even if you have a $0-premium plan, you could end up with a monthly bill if your income is above a certain threshold. The income-related monthly adjustment amount (IRMAA) is a surcharge that applies to your Medicare Part B and Part D premiums. The Part D surcharge applies even if your drug coverage is bundled into your Medicare Advantage plan with no separate premium.
In 2026, IRMAA applies to you if your modified adjusted gross income from 2024 is above $109,000 if you’re filing individually or $218,000 if you’re married and filing jointly.
» MORE: What is the Medicare IRMAA?
Your out-of-pocket costs on Medicare Advantage
Monthly premiums only tell part of the story.
Say you break your leg. This might involve a trip to the emergency room, follow-up appointments with specialists and physical therapists, and prescription medication. All of these services come with out-of-pocket costs, and these are the costs that can run high with a Medicare Advantage plan, especially if you need a lot of care.
Here’s a breakdown of what you’ll pay when you actually need to use your Medicare Advantage plan.
Deductibles
This is the amount you have to pay before your plan starts covering eligible services. Medicare Advantage plans often have two deductibles: one for medical services and a separate one for prescription drugs. Both vary by plan. Some set them to $0, and the drug deductible is capped at $615 in 2026.
While a low or $0 deductible is a nice perk, I wouldn’t weigh it too heavily when comparing plans. Costs like premiums, coinsurance and copayments tend to play a bigger role in determining your overall healthcare costs.
Coinsurance and copayments
Even after you meet your deductible, your Medicare Advantage plan isn’t going to pay 100% of your medical costs. Each time you seek care, you split the bill with your insurer. How you split it depends on whether the service you’re seeking comes with coinsurance or a copayment.
- Copayment: A flat fee you pay for a specific service, such as $45 for each specialist visit or $115 for an emergency room trip.
- Coinsurance: The percentage of your bill you’re responsible for. If you have a 20% coinsurance, you pay 20% of the total cost and your insurer pays 80%.
Every plan lists what you’ll pay for each type of care in the summary of benefits. We analyze thousands of Medicare Advantage plans each year at NerdWallet, and I’ve consistently seen plans use copays for the vast majority of in-network care.
Coinsurance commonly appears in a few key areas: out-of-network care, dental procedures and higher-cost prescription drugs. Preferred brand-name drugs are one area where plans often split — some charge a copay, while others charge coinsurance.
What's better: Copays or coinsurance?
Say your doctor prescribes a daily inhaler like Breztri Aerosphere for asthma and COPD. The manufacturer’s list price for a 30-day supply of Breztri Aerosphere, a popular brand-name inhaler with no generic alternative, is about $680 .
- With a copay: If your plan charges a $47 copay on preferred brand-name drugs, you know exactly how much it will cost to fill your prescription.
- With coinsurance: If your plan charges a 25% coinsurance instead, your cost changes depending on your pharmacy’s price for the drug. If they charge $680, you’d pay $170 — nearly four times as much as the copay.
Copayments are easier to plan for, and the flat rate can keep your bills from spiraling when you seek expensive care. But if the copays are high and you need frequent care, your costs can still snowball.
Nerdy Perspective
Inpatient hospital copays: One area where Medicare Advantage costs add up
Hospital stays are where I see some of the highest copay requirements in Medicare Advantage plans. A plan might charge $495 per day for the first five days of your stay. That could add up to nearly $2,500, and you might have to pay that multiple times if you’re hospitalized again later in the year.
If you worry you'll be in and out of the hospital, look for plans with lower inpatient copays. You could also opt for Original Medicare with a Medigap plan to get additional coverage for those out-of-pocket costs.
If you worry you'll be in and out of the hospital, look for plans with lower inpatient copays. You could also opt for Original Medicare with a Medigap plan to get additional coverage for those out-of-pocket costs.
Out-of-network care
Many Medicare Advantage plans don’t cover out-of-network care for non-emergencies. Even those that do (usually PPO plans) charge more for it. They often apply a coinsurance to out-of-network care and a flat copay to in-network care. Plans can also set a higher out-of-pocket limit for out-of-network care.
Say you need a hip replacement at a hospital outpatient department, and your Medicare Advantage PPO plan covers out-of-network care. If you go to an in-network hospital, you might end up paying a $375 copay. But if you go out-of-network, you’d pay a 40% coinsurance instead. The Medicare-approved amount for this procedure is around $14,278, so 40% of that means you’d end up paying about $5,711.
Maximum out-of-pocket cost
Medicare Advantage plans are required to have a limit on what you can pay out of pocket each plan year. That limit can’t be higher than $9,250 in 2026 for in-network services, and many plans have an even lower limit. The average out-of-pocket limit for in-network services on Medicare Advantage plans is about $6,120 in 2026, according to NerdWallet analysis of CMS data.
This is the number to pay attention to if you’re worried about worst-case-scenario costs, especially since it can vary widely and isn’t necessarily higher on cheaper plans.
For example, most of SCAN Health Plan’s Medicare Advantage plans (87%) have a $0 premium, and their average max out-of-pocket is $1,563. On the flip side, less than half of Wellcare’s Medicare Advantage plans (47%) come with a $0 premium, and the insurer’s average max out-of-pocket is $7,362.
Your prescription drug benefits have their own separate cap: Medicare limits out-of-pocket drug spending to $2,100 in 2026.
Dental, vision and hearing coverage
Most Medicare Advantage plans come with extras like some dental, vision and hearing coverage. While these benefits are included in the cost of your plan, they might not cover a lot. They often come with copays and an annual limit on how much they’ll pay out.
» MORE: Best Medicare dental plans
What $0-premium Medicare Advantage plans actually cost
To get a sense of your potential costs, here are three sample plans based on real Medicare Advantage plans from the 2026 plan year. While all three have a $0 monthly premium, the maximum you could spend on out-of-pocket costs for in-network care ranges from $4,750 to $8,800. (Prescription drugs come with a separate out-of-pocket maximum that can be up to $2,100 in 2026.)
$0
Monthly premium
$4,750
Out-of-pocket max
Standout feature
Lowest cap on out-of-pocket costs.
Deductible
$0 (medical).
Copays
Doctor visits:
$0 PCP, $30 specialist.
$0 PCP, $30 specialist.
Emergencies:
$130 ER, $50 urgent.
$130 ER, $50 urgent.
Hospital stay:
$395/day (days 1–5).
$395/day (days 1–5).
Dental benefits
Up to $2,500/year.
$0
Monthly premium
$6,750
Out-of-pocket max
Standout feature
See out-of-network providers (higher cost).
Deductible
$0 (medical).
Copays
Doctor visits:
$0 PCP, $45 specialist.
$0 PCP, $45 specialist.
Emergencies:
$130 ER, $50 urgent.
$130 ER, $50 urgent.
Hospital stay:
$495/day (days 1–5).
$495/day (days 1–5).
Dental benefits
Up to $1,500 per year.
$0
Monthly premium
$8,800
Out-of-pocket max
Standout feature
Get $61/month toward your Part B premium.
Deductible
$500 (medical).
Copays
Doctor visits:
$0 PCP, $45 specialist.
$0 PCP, $45 specialist.
Emergencies:
$115 ER, $40 urgent.
$115 ER, $40 urgent.
Hospital stay:
$489/day (days 1–5).
$489/day (days 1–5).
Dental benefits
Up to $1,000 per year.
In-network costs. All plans have a $615 prescription drug deductible. Example plan, not a recommendation.
You might assume the low-cap plan is the best deal at first glance, and for many, it is. It has low copays and the lowest limit on your out-of-pocket costs. No matter what happens, you won’t spend more than $4,750 in a given year on covered in-network medical care. It also offers the most generous dental benefit.
However, the flexible plan allows you to seek out-of-network care. While that comes with higher copays and a higher out-of-pocket limit, it might still cost you less than one of the other plans if you end up having to see a doctor who isn’t in network.
The Giveback plan is the riskiest if you get sick or become injured. Even if you only see in-network providers, you could spend up to $8,800 per year on out-of-pocket costs. It’s the only plan with a deductible on medical services, and it has the least generous dental benefit. But it also has the potential to save you the most money if you don’t end up needing much care, thanks to the Giveback benefit. It gives you $61 per month toward your Medicare Part B premium, which saves you $732 per year.
Shopping for Medicare Advantage plans? We have you covered.
MEDICARE ADVANTAGE is an alternative to traditional Medicare offered by private health insurers. Compare options from our Medicare Advantage roundup. | |
Best major company | Best for size of network |
Best government ratings | Best for low-cost plan availability |
Medicare Advantage plan costs by state
Medicare Advantage plans vary by location, so your costs will depend in part on where you live. Click on a state on the map below to see the best Medicare Advantage plans available in that state.
If you can afford to pay a higher monthly premium, Medicare Supplement Insurance is worth considering for its lower out-of-pocket costs. Also known as Medigap, this supplemental insurance covers gaps in Original Medicare coverage, making it easier to budget for unexpected medical costs.
Medigap premiums range from around $50 to $200 or more per month. But your medical and hospital costs on Medigap are minimal. For example, Medigap Plan G, the most popular Medigap plan, covers nearly all your out-of-pocket costs aside from the Part B deductible, which is $283 in 2026. And that cost doesn’t increase if you go out of network.
You can only buy a Medigap plan if you’re on Original Medicare, so you have to choose between Medicare Advantage and Medigap. The best time to sign up for Medigap is when you first become eligible for Medicare.
Get more information below about some of the major Medicare Supplement Insurance companies. These insurers offer Medigap plans in most states, but specifics may vary depending on your location.
Article sources
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- 1.NerdWallet analysis of CMS data. CY2026 Landscape 202608. Accessed Aug 18, 2026.
- 2.Centers for Medicare & Medicaid Services. Costs. Accessed Aug 18, 2026.
- 2.Centers for Medicare & Medicaid Services. Costs. Accessed Aug 18, 2026.
- 4.Breztri Aerosphere. Cost Information. Accessed Aug 18, 2026.
- 5.Centers for Medicare & Medicaid Services. Medicare Advantage and Medicare Prescription Drug Programs Expected to Remain Stable in 2026. Accessed Aug 18, 2026.
- 6.NerdWallet analysis of CMS data. CY2026 Landscape 202603. Accessed Aug 18, 2026.
