How is Medicare C funded?

Asked by: Dr. Vella Hagenes  |  Last update: November 5, 2025
Score: 4.3/5 (54 votes)

Medicare Advantage, or Part C, is a health insurance program funded by two different sources: monthly premiums from beneficiaries and the Centers for Medicare & Medicaid Services. This federal agency runs the Medicare program. Private insurance companies manage Advantage plans.

Who pays Medicare Part C premiums?

Your Part B Medicare premiums are billed directly through Medicare, while your Part C premiums are billed through the private insurance company associated with your Medicare Advantage plan. Here's how you pay Medicare and your private insurance company.

How is Medicare Part C provided?

Medicare Advantage (also known as “Part C”) is a Medicare-approved plan from a private company that offers an alternative to Original Medicare for your health coverage. These “bundled” plans include Part A, Part B, and usually Part D. Plans may offer some extra benefits that Original Medicare doesn't.

How is Medicare Part C funded?

Medicare Advantage, or Part C, is a health insurance program funded by two different sources: monthly premiums from beneficiaries and the Centers for Medicare & Medicaid Services. This federal agency runs the Medicare program. Private insurance companies manage Advantage plans.

Can I get Medicare Part C for free?

The cost of Medicare Part C plans (also known as Medicare Advantage plans) varies depending on where you live and the plan you choose. Some plans have $0 monthly premiums. You still have to pay your Part A and Part B monthly premiums.

What Does Medicare Part C Cover? | Medicare Advantage

43 related questions found

What is the biggest disadvantage of the Medicare Advantage plan?

Medicare Advantage Plan Pros And Cons

One disadvantage is that some Medicare Advantage plans may offer fewer options when it comes to doctors and hospitals, as they may have smaller plan networks than Original Medicare.

Why is Medicare Part C so cheap?

Medicare Advantage plans differ in coverage and costs, even those sponsored by the same insurance company. Some plans even have $0 premiums or $0 deductibles, though all require you to still pay your Part B premium. (Medicare Advantage plans are partially funded by Medicare, which is why costs are so low.)

Why are hospitals refusing Medicare Advantage plans?

Among the most commonly cited reasons are excessive prior authorization denial rates and slow payments from insurers. In 2023, Becker's began reporting on hospitals and health systems nationwide that dropped some or all of their Medicare Advantage contracts.

Does Medicare Part C pay 100 percent?

Medicare Advantage Plan (Part C):

Deductibles, coinsurance, and copayments vary based on which plan you join. Plans also have a yearly limit on what you pay out-of-pocket. Once you pay the plan's limit, the plan pays 100% for covered health services for the rest of the year.

What is the two midnight rule for Medicare Advantage?

The two-midnight presumption directs medical reviewers to select Original Fee-for-Service Medicare Part A claims for review under a presumption that hospital stays that span two midnights after an inpatient admission are reasonable and necessary Part A payment.

What is the best Medicare plan that covers everything for seniors?

Original Medicare with Medigap likely offers the most comprehensive coverage, but it may also be the most costly. A person can consider their income and how much they are able to spend before choosing a Medicare plan. Original Medicare with Medigap also offers a lot of flexibility when choosing a doctor or specialist.

Why is original Medicare better than Medicare Advantage?

Medicare Advantage plans typically require that you use care providers within a geographic service area, and once you get outside that area, you'll be covered for emergency care only. Original Medicare offers access to a national network of providers — no matter where you are in the U.S. Like to minimize risk.

What is the disadvantage of UnitedHealthcare for seniors?

Cons About UnitedHealthcare Medicare Advantage

You may only have access to certain HMO or PPO plans in your area. And while UnitedHealthCare has competitive pricing, your location may only have access to plans with higher deductibles, more copays, and fewer additional benefits.

Is it a good idea to get Medicare Part C?

If you have Original Medicare and just need a plan for prescription medications, Medicare Part D is the best choice. When you require more coverage for dental, vision, or prescription drugs, Medicare Part C plans provide more options to fit your healthcare needs.

Does everyone have to pay $170 a month for Medicare?

Most people pay no premiums for Part A. For Medicare Part B in 2025, most beneficiaries will pay $185 per month. Certain factors may require you to pay more or less than the standard Medicare Part B premium in 2025.

Does Medicare Part C cover dental implants?

Medicare Advantage plans (Part C) offer a broader range of benefits, and some may include implant coverage. However, benefits and costs differ between plans, so it's essential to review options carefully. If implants aren't covered, alternative solutions like dental insurance or discount programs can help offset costs.

What are the top 5 medicare supplement plans?

💬 From our Nerds: What are the top five Medicare supplement plans? "Based on NerdWallet's Medigap rubric, I picked five best Medicare Supplement Insurance companies for 2025: AARP/UnitedHealthcare, Mutual of Omaha, State Farm, Anthem and Blue Cross Blue Shield.

How do you qualify for $144 back from Medicare?

To be eligible for the Medicare Part B Giveback Benefit, you must:
  1. Be enrolled Original Medicare (Parts A and B)
  2. Pay your own Part B premium.
  3. Live in the service area of a plan that offers a Part B giveback.

Can you buy Medicare Part C by itself?

You can only join, switch, or drop a Medicare Advantage Plan (Part C) or Medicare drug plan (Part D) during certain times, called enrollment periods. You need both Medicare Part A (Hospital Insurance) and Part B (Medical Insurance) to join a Medicare Advantage Plan.