Medicare Advantage (Part C) is chosen by nearly half of all Medicare beneficiaries — and for good reason. These private insurance plans replace Original Medicare with bundled coverage that often includes dental, vision, hearing, and drug benefits at $0 monthly premium. The trade-off: network restrictions, prior authorization requirements, and potentially higher costs if you have a serious health event.
This guide ranks the best Medicare Advantage companies and plans for 2026, explains how to compare plans in your area, and helps you decide whether Advantage is right for you.
Best Medicare Advantage Companies (2026)
Company
Avg. CMS Star Rating
Plans Available
States
Monthly Premium Range
Enrollment (Millions)
Best For
Kaiser Permanente
4.5+ stars
HMO
8 states + DC
$0–$80
1.8
Highest member satisfaction
UnitedHealthcare (AARP)
4.0 stars
HMO, PPO
50 states
$0–$100
8.5
Broadest availability
Humana
4.0 stars
HMO, PPO
47 states
$0–$75
5.8
Strong PPO options
Blue Cross Blue Shield
3.5–4.5 stars
HMO, PPO
All states (varies)
$0–$90
4.2
Local market strength
Aetna (CVS Health)
3.5–4.0 stars
HMO, PPO
45 states
$0–$85
3.5
CVS pharmacy integration
Cigna
3.5–4.0 stars
HMO, PPO
30+ states
$0–$70
1.2
Competitive premiums
Centene (WellCare)
3.5 stars
HMO, PPO
40+ states
$0–$60
2.5
Low-income/dual-eligible
CMS Star Ratings Explained
Stars
Quality Level
What It Means
5 stars
Excellent
Top quality — may offer year-round enrollment
4–4.5 stars
Above average
Strong performance across quality measures
3–3.5 stars
Average
Meets minimum standards
2–2.5 stars
Below average
Quality concerns — consider alternatives
1–1.5 stars
Poor
Significant problems — avoid if possible
Always check star ratings before enrolling. Plans rated 5 stars allow year-round enrollment (not just during open enrollment). CMS ratings evaluate healthcare outcomes, member satisfaction, customer service, and complaint data.
Best Medicare Advantage Plans by Region
Northeast (NY, NJ, CT, MA, PA)
Company
Top Plan Type
Avg. Premium
Star Rating
Strengths
Empire BCBS
HMO/PPO
$0–$50
4.0
Strong hospital networks
UnitedHealthcare
HMO/PPO
$0–$60
4.0
Broadest provider network
Aetna
HMO/PPO
$0–$45
3.5
CVS MinuteClinic access
Southeast (FL, GA, NC, SC, VA)
Company
Top Plan Type
Avg. Premium
Star Rating
Strengths
Humana
HMO/PPO
$0–$35
4.0
Largest FL presence
UnitedHealthcare
HMO/PPO
$0–$40
4.0
Wide availability
Cigna
HMO
$0–$30
3.5
Low premiums
Midwest (OH, MI, IL, MN, WI)
Company
Top Plan Type
Avg. Premium
Star Rating
Strengths
UnitedHealthcare
HMO/PPO
$0–$50
4.0
Dominant regional presence
Humana
HMO/PPO
$0–$45
4.0
Strong PPO network
BCBS (local)
HMO/PPO
$0–$55
4.0–4.5
Local hospital relationships
West (CA, WA, OR, CO)
Company
Top Plan Type
Avg. Premium
Star Rating
Strengths
Kaiser Permanente
HMO
$0–$80
4.5+
Best integrated care
UnitedHealthcare
HMO/PPO
$0–$55
4.0
PPO flexibility
Blue Shield of CA
HMO/PPO
$0–$40
4.0
CA-specific strength
Southwest (TX, AZ, NM, NV)
Company
Top Plan Type
Avg. Premium
Star Rating
Strengths
UnitedHealthcare
HMO/PPO
$0–$45
4.0
Broadest TX network
Humana
HMO/PPO
$0–$35
4.0
Competitive pricing
Aetna
HMO/PPO
$0–$40
3.5
CVS integration in urban areas
Medicare Advantage Plan Types
Plan Type
Network Restriction
Out-of-Network Coverage
Referral Needed?
Best For
HMO
Must use network providers
Emergencies only
Yes (usually)
Lowest premiums, willing to stay in-network
PPO
In-network preferred, out-of-network allowed
Yes (at higher cost)
No
Flexibility to see any doctor
HMO-POS
HMO with limited out-of-network option
Limited
Some services
HMO with occasional out-of-network need
PFFS
Any Medicare provider who accepts plan terms
N/A
No
Rural areas with limited networks
SNP
Network-based
Varies
Varies
Dual-eligible, chronic conditions, institutional
What Medicare Advantage Covers (Beyond Original Medicare)
Benefit
Original Medicare
Typical MA Plan
Value
Hospital (Part A)
✓
✓
Included
Medical (Part B)
✓
✓
Included
Prescription drugs (Part D)
Separate plan needed
Usually included
Save $20–$40/month
Dental
✗
Basic included (cleanings, X-rays)
$500–$2,000/year value
Vision
✗
Basic included (exams, $100–$200 eyewear)
$300–$500/year
Hearing
✗
Exams + hearing aid allowance
$500–$3,000/year
Fitness (SilverSneakers/gym)
✗
Often included
$300–$600/year
OTC allowance
✗
$25–$100/quarter for OTC items
$100–$400/year
Transportation
✗
Some plans offer rides to appointments
Varies
Telehealth
Limited
Expanded virtual visits
Convenience
Medicare Advantage Costs Explained
What You Pay with Medicare Advantage
Cost
Amount
When You Pay
Part B premium
$185/month (2026)
Always — paid regardless of plan choice
MA plan premium
$0–$100/month (many plans $0)
Monthly
Primary care copay
$0–$25 per visit
When you visit
Specialist copay
$25–$50 per visit
When you visit
ER copay
$50–$120 (waived if admitted)
When you visit
Hospital copay
$100–$400/day (days 1–5)
Per admission
Drug copays
$0–$100 depending on tier
Per prescription
Out-of-pocket maximum
$3,000–$8,300/year
Maximum you’ll pay
Cost Comparison: Medicare Advantage vs. Medigap
Scenario
Medicare Advantage (Typical HMO)
Original Medicare + Medigap Plan G
Monthly premiums
$0 MA + $185 Part B = $185
$155 Medigap + $185 Part B + $30 Part D = $370
Annual premiums
$2,220
$4,440
Healthy year (2 office visits)
$2,260
$4,697
Moderate year ($15K in charges)
$3,500–$4,500
$4,697
Major event ($100K surgery)
$7,000–$10,500
$4,697
Worst case (hit MOOP)
$10,520
$4,697
The crossover point: Medicare Advantage saves money in healthy years but costs more in high-expense years. If you have a major health event, Medigap limits your costs more effectively.
How to Choose a Medicare Advantage Plan
Step-by-Step Selection Process
Step
Action
Tool
1
Check which plans are available in your ZIP code
Medicare.gov Plan Finder
2
Verify your doctors are in-network
Plan’s provider directory
3
Check your prescriptions are covered
Plan’s formulary
4
Compare star ratings
Medicare.gov
5
Compare total estimated costs (premiums + copays)
Medicare.gov cost estimator
6
Review extra benefits (dental, vision, hearing)
Plan summary
7
Check prior authorization requirements
Plan documents
Red Flags to Watch For
Red Flag
Why It Matters
Star rating below 3.0
Quality concerns, member complaints
Your doctor not in-network
Must switch doctors or pay more
High specialist copays ($50+)
Adds up fast with chronic conditions
Strict prior authorization
Delays in getting approved care
Narrow formulary (limited drugs)
Your medications may not be covered or may cost more
High out-of-pocket maximum ($8,000+)
More financial risk in bad health year
Plan exits your county next year
Must switch plans (happens more often with smaller insurers)
Medicare Advantage Enrollment Periods
Period
When
What You Can Do
Initial Enrollment
3 months before to 3 months after turning 65
Join any available MA plan
Annual Enrollment (AEP)
October 15 – December 7
Switch MA plans or return to Original Medicare
Open Enrollment (OEP)
January 1 – March 31
Switch MA plans or drop MA for Original Medicare
Special Enrollment
Triggered by life events (move, lose coverage)
Join or switch plans
5-Star Enrollment
Year-round
Switch to any 5-star rated plan
Medicare Advantage vs. Original Medicare: Decision Guide
Choose Medicare Advantage If…
Choose Original Medicare + Medigap If…
You want low monthly premiums
You want maximum doctor choice
You’re comfortable with a network
You travel frequently or are a snowbird
You want dental, vision, hearing included
You want predictable costs regardless of health
You’re generally healthy
You have chronic conditions or expect major care
You don’t mind prior authorization
You want to see any specialist without referral
Your doctors accept MA plans
You worry about large medical bills
Drug coverage bundled is convenient
You’re willing to pay more for comprehensive coverage
Can I switch from Medicare Advantage back to Original Medicare?
Yes, during the Annual Enrollment Period (October 15 – December 7) or the Open Enrollment Period (January 1 – March 31). However, if you want to add a Medigap policy, insurers can medically underwrite you and may deny coverage based on health conditions — unless you’re in a state with guaranteed-issue protections (CT, ME, NY).
Do Medicare Advantage plans change every year?
Yes. Plans can change premiums, copays, drug formularies, provider networks, and extra benefits annually. You should review your plan every fall during the Annual Enrollment Period and compare it to alternatives on Medicare.gov.
Is Medicare Advantage available everywhere?
Medicare Advantage plans are available in most U.S. counties, but the number and quality of plans varies significantly. Urban areas typically have 20–50+ plan options. Rural areas may have only 2–5 options or none in the most remote counties.
What happens if my doctor leaves my MA plan’s network?
If your doctor leaves the network mid-year, most plans provide a transition period (typically 90 days) where you can continue seeing that doctor at in-network rates. After that, you’d need to find a new in-network doctor or pay higher out-of-network costs.
WealthVieu researches and writes data-driven personal finance guides using primary sources including the IRS, Bureau of Labor Statistics, Federal Reserve, and Census Bureau.
The content on Wealthvieu is for informational purposes only and should not be considered financial, tax, or investment advice. Consult a qualified professional before making financial decisions. Full disclaimer · Editorial policy
