What Are the Costs of Medicare Advantage?

Offered through private health plans, Medicare Advantage (also known as Part C) gives you an alternative way to receive your Medicare coverage. Like with original Medicare (Parts A and B), Medicare Advantage is not free—you will be responsible for paying certain costs yourself. These are often referred to as “out of pocket” costs and include premiums, deductibles, coinsurance, and copayments. Understanding these expenses can help you compare plans and estimate your total health care spending.

Here's a breakdown of Medicare Advantage costs and out-of-pocket expenses for 2026—and what’s expected for 2027.

What are the Medicare Advantage (Part C) premiums for 2026?

Premiums are the amount you pay each month out-of-pocket for your Medicare Advantage plan. The average monthly Medicare Advantage plan premium in 2026 is around $14—but it varies based on the insurer and level of coverage. According to the Centers for Medicare & Medicaid Services (CMS), this average cost is projected to drop to $12.00 in 2027. Some plan premiums could be $0, while others could be $200 or more. 

To join a Medicare Advantage plan, you must also be enrolled in Medicare Parts A and B. Part B has a separate premium that you must pay even if you enroll in a Medicare Advantage plan. The standard Part B premium in 2026 is $202.90 per month, projected to increase to $209.50 in 2027 based on the 2026 Medicare Trustees Report. You may pay more if you delayed enrolling into Medicare Part B and have a penalty, have higher income, and/or have fewer than 40 Social Security work credits.

What are the deductibles for Medicare Advantage?

A deductible is the amount you must pay before your Medicare benefits kick in. Only some Medicare Advantage plans have an annual deductible. However, many Medicare Advantage plans that include Part D/prescription drug coverage may charge a separate deductible for drug coverage. The maximum deductible Part D plans can implement in 2026 is $615. This will increase to $700 in 2027.

Are there copayments (or coinsurance) for Medicare Advantage? 

Copayments/coinsurance are the portion of costs you pay for covered drugs or services like doctor visits. Copayments are usually a flat fee, while coinsurance is generally a percentage of the cost of the item or service. For example, a 25% coinsurance means you are responsible for 25% of the total cost, while the plan covers 75% of the total cost. Keep in mind Medicare Advantage plans often charge higher copayment and coinsurance amounts for out-of-network providers.

Are there maximum out-of-pocket costs for Medicare Advantage in 2026? 

Medicare Advantage out-of-pocket costs can vary by plan and change every year. But all Part C plans have a maximum out-of-pocket spending limit. In 2026, the maximum you will spend is $9,250 (some plans may have lower limits). The cap will increase to $9,850 in 2027. This limit is designed to protect you from excessive costs if you have an injury or illness and your medical expenses are high.

If your Medicare Advantage plan allows you to see out-of-network providers, it may have a separate out-of-network, out-of-pocket spending limit that’s higher. Additionally, if your plan includes prescription drug coverage, you will have a separate out-of-pocket maximum for prescription drug costs.

Medicare Advantage Costs: A Preview of 2027

*Amounts are pending final updates from CMS.

What changes are coming to Medicare Advantage in 2027?

Some changes expected to impact Medicare Advantage plans (including plans that incorporate Part D coverage) in 2027 include:

• Many plan providers are reducing, restricting, or eliminating the number of additional benefits they offer (e.g. vision, dental, non-medical transportation, and fitness benefits).
• Cost sharing may increase for some plans, including copayments and out-of-pocket spending caps.
• Some insurers are limiting enrollment in particular plans, which means a plan may not be available to everyone who would like to enroll.
• Medicare Advantage plans are being discontinued in certain service areas. Those in rural areas will have fewer coverage choices; some may need to consider original Medicare or other coverage options.
• The Part A deductible is projected to increase to $1,788. The standard Part B monthly premium is projected to rise to $209.50, while the Part B deductible is projected to increase to $292. 
• The average monthly Part C premium will drop to $12, while the maximum out-of-pocket spending cap will increase to $9,850.
• The Part D deductible will increase to $700, while the annual cap on beneficiaries' out-of-pocket costs for covered Part D drugs will increase to $2,400. The Part D base monthly premium will increase to $41.33.

“Rising health care costs, insurance company decisions, and changes in federal payments all play a role in what Medicare Advantage plans offer,” explained said Ryan Ramsey, NCOA Associate Director of Health Coverage and Benefits. “Before electing Medicare coverage for 2027, look closely at what’s changing and what it could mean for your care, your budget, and the doctors and services you rely on.”

Are there additional considerations when choosing a Medicare Advantage plan?

When you’re comparing Medicare Advantage plans, keep the following in mind:

• If you’re enrolled in a Medicare Advantage plan that operates as a health maintenance organization (HMO), you’ll need a referral from your primary care physician to visit a specialist. There will be a separate copayment for that appointment.
• If you’re enrolled in an HMO, be sure that any specialist you see refers you to an in-network lab or testing facility.
• If you’re enrolled in a Medicare Advantage Special Needs Plan (SNP), most of your out-of-pocket costs are typically covered by Medicare and Medicaid.

Enrolling in a Medicare plan is a big decision—and NCOA is here to help you make the right one during Open Enrollment (Oct. 15-Dec. 7). Review our practical tips for choosing a Medicare plan.