Medicare Advantage (Part C)
One card for hospital, medical and usually drugs, with extras built in.
Overview
Medicare Advantage plans are offered by private insurance companies under contract with Medicare. You still have Medicare, and you keep paying your Part B premium, but the plan handles your claims and sets its own copays, networks and extra benefits.
In Sarasota and Manatee counties there are dozens of HMO and PPO options each year, many with a $0 plan premium. The right one depends almost entirely on your doctors, your hospital preference and your prescriptions, which is exactly what we check for you.
Every Advantage plan has an annual maximum out-of-pocket limit, so a bad year has a ceiling. The trade-off is network rules, prior authorizations and copays as you use care.
What's included
Everything in Parts A and B
Plans must cover everything Original Medicare covers, often with different cost sharing.
Prescription drugs
Most plans (MAPD) include Part D with tiered copays at preferred pharmacies.
Routine dental
Cleanings and exams, and on many plans an allowance for fillings, crowns or dentures.
Vision and eyewear
An annual eye exam and an allowance for glasses or contacts.
Hearing aids
Hearing exams and hearing aid benefits through a plan partner.
Fitness and OTC
Gym memberships and quarterly over-the-counter allowances on many local plans.
How we help you choose
Our process for medicare advantage takes about an hour of your time, spread over one or two conversations.
List your doctors and drugs
We gather your providers, hospital preference and prescription list, including dosages.
Run a network and formulary check
We search every plan we represent in your ZIP code for your doctors and drugs.
Compare total yearly cost
Premium plus expected copays plus drug costs, not just the premium line.
Enroll and follow up
We submit the application, confirm your ID card arrives, and call you in January.
Why people choose it
A ceiling on bad years
The out-of-pocket maximum limits what you pay for covered medical services.
Extras Original Medicare skips
Dental, vision, hearing and fitness benefits bundled into one plan.
Often $0 plan premium
Many local plans charge no premium beyond your Part B.
What it costs
Costs depend on your county, carrier and income. These sample figures help you budget.
| Cost | Sample amount | Good to know |
|---|---|---|
| Plan premium | $0 - $120/mo | Sample range for Sarasota County plans |
| Primary care copay | $0 - $15 | In-network, varies by plan |
| Specialist copay | $20 - $50 | In-network, varies by plan |
| In-network out-of-pocket max | $3,900 - $9,250 | Federal limit for 2026 is $9,250 (sample) |
| Part B premium | Still paid | Some plans include a Part B give-back |
Figures are samples for illustration and are not a quote. Confirm current amounts on Medicare.gov or with a licensed agent.
Medicare Advantage questions
Ask us anything else on a free call.
Only if they are in the plan's network, or if you choose a PPO that pays out of network at a higher cost. We check each doctor before you enroll.
Emergency and urgent care are covered nationwide. Routine care away from home depends on the plan, and some PPOs have travel programs for snowbirds.
Yes, during the Annual Enrollment Period or the Medicare Advantage Open Enrollment Period. Buying a Supplement later may require health questions in Florida.
Medicare pays the carrier a set amount each month to manage your care. Carriers compete on benefits, and some can offer no premium in our area.
Get help with Medicare Advantage
Free, no-pressure help comparing the plans we offer in your county. Most calls take about 20 minutes.
Licensed agents. TTY 711. Mon-Fri 8am-8pm, Sat 9am-2pm ET.
