Medicare Advantage (MA), also known as Medicare Part C, is often marketed as a simple, affordable alternative to original Medicare. Medicare Advantage can be a good fit for many seniors, but confusion about how these plans work and how they differ from original Medicare can lead to disappointment and unexpected costs.
Understanding Medicare Advantage means looking beyond marketing headlines and examining how coverage works in real life. Below are seven common misunderstandings about Medicare Advantage, along with facts to clarify them.
Misunderstanding #1: Medicare Advantage plans are “free”
The misunderstanding: Many people believe that if a plan advertises a “$0 premium,” it means Medicare Advantage is free, with no costs beyond enrollment.
The reality: While some Medicare Advantage plans charge no additional monthly premium, you must still pay your Medicare Part B premium to be enrolled in MA. (In 2026, the standard Part B monthly premium is $202.90 for most beneficiaries.)
In addition, Medicare Advantage plans typically include copayments, deductibles, and coinsurance for the medical services you use.
In other words, a $0 premium plan does not mean zero out-of-pocket costs. Your total expenses depend on the plan you choose, how often you use medical care, and the services you need. When comparing plans, you should review the expected total costs, not just premiums.
Misunderstanding #2: You can see any doctor you want
The misunderstanding: Some people assume that if you have Medicare, you can go to any doctor or hospital.
The reality: Medicare Advantage plans are offered by private insurers. With the federal government’s original Medicare, you can see any doctor or hospital that accepts Medicare, but MA plans operate within each plan’s provider network. You’ll need to use in-network doctors and hospitals for routine care.
Seeing providers outside the network may result in higher costs or no coverage at all, depending on the plan.
Various types of Medicare Advantage plans exist. Some plans (like PPOs) may let you see out-of-network doctors at a higher cost, but others (like HMOs) may not. Also, Advantage plans may require prior authorization for certain services, which original Medicare traditionally does not.
Misunderstanding #3: Medicare Advantage works the same way when you travel as when you’re at home
The misunderstanding: Many seniors assume their Medicare Advantage coverage travels seamlessly with them.
The reality: Medicare Advantage plans are geography-based. Emergency and urgent care may be covered nationwide, but routine, non-emergency care is generally covered only within the plan’s service area and network.
This can be a meaningful limitation for:
- Snowbirds who live in two states.
- Retirees who travel extensively.
- People with adult children and specialists in different regions.
Some PPO plans offer limited out-of-network coverage. However, rules and costs vary and should be carefully reviewed before you enroll in a plan.
By contrast, original Medicare lets beneficiaries see any provider nationwide who accepts Medicare, offering greater flexibility for those who value geographic freedom.
Misunderstanding #4: Extra benefits are unlimited or equivalent to traditional insurance coverage
The misunderstanding: Medicare Advantage often advertises extras such as dental, vision, and hearing benefits without providing details about them. Some people believe these are equivalent to traditional insurance plans with comprehensive coverage.
The reality: Most Medicare Advantage plans do include extra benefits that original Medicare doesn’t offer. While this can seem attractive, these benefits often come with many restrictions, such as:
- Which services are covered.
- How long you must wait before certain services are available.
- A maximum dollar amount the plan will spend each year.
For example, dental coverage may include exams and cleanings but not complete dentures or advanced procedures. If the annual dollar limit is very low, you may have to pay out of pocket for the services you need.
One source indicates that Medicare Advantage plans cover about a quarter of the total cost of dental, vision, and hearing services for their beneficiaries.
These extra benefits can be valuable, but you could be disappointed if you expect them to provide comprehensive coverage.
Misunderstanding #5: Once you choose a Medicare Advantage plan, you’re stuck with it
The misunderstanding: Many seniors worry that enrolling in Medicare Advantage permanently locks them in, no matter how their health needs change.
The reality: Medicare has several designated enrollment periods that allow you to switch or change plans:
- The annual open enrollment period (October 15 to December 7) is when you can switch between original Medicare and Medicare Advantage or between MA plans.
- Medicare Advantage open enrollment (January 1 to March 31) is when you can switch to another Advantage plan or return to original Medicare if you’re already in an Advantage plan.
- Special enrollment periods are triggered by life changes such as moving out of your plan’s service area or losing other coverage.
One warning: If you switch back to original Medicare after first having a Medicare Advantage plan for longer than the 12-month trial period, you may not be able to buy a Medigap policy without medical underwriting, depending on timing and circumstances. This is an important consideration when making your initial choice.
Misunderstanding #6: Medicare Advantage is always more expensive
The misunderstanding: Because Medicare Advantage is privately managed and offers additional benefits, some people assume it costs more than original Medicare.
The reality: One system doesn’t automatically cost more or less than the other. Medicare Advantage can be more economical for some beneficiaries, but the cost depends on the plan you choose and how you use it.
For example, out-of-pocket expenses under original Medicare are open-ended (unless you pay an additional monthly premium to add a private Medigap plan). Medicare Advantage plans do have maximum annual out-of-pocket limits. However, while maximums are usually set much lower, in 2026, they can legally reach $9,250 for in-network care. The key is to research plans carefully before making a choice.
Many Medicare Advantage plans bundle prescription drug coverage and supplemental benefits into a single policy, which can sound economical. While this structure can reduce total costs, it can also increase them if you need frequent or out-of-network care.
Misunderstanding #7: All Medicare Advantage plans are basically the same
The misunderstanding: Plans are sometimes seen as interchangeable.
The reality: Medicare Advantage plans vary widely by:
- The size and composition of the network.
- How costs are shared.
- Prescription drug formularies.
- Referral requirements.
- Extra benefits.
A plan that works well for one person may be a poor fit for another, even within the same zip code. For example, a plan with strong prescription drug coverage might not include your favorite specialist in its network. Another plan with better dental benefits might require referrals for every specialist visit.
Comparing plans carefully each year is essential, especially if your health needs, medications, or providers change.
Wrapping up
Medicare Advantage can be a valuable option for many seniors, offering bundled coverage, extra benefits, and predictable cost limits. However, misunderstandings about how these plans work can lead to confusion and costly surprises.
Before choosing a plan, take the time to:
- Review the network of doctors and hospitals included.
- Compare total expected costs, not just premiums.
- Confirm coverage for your regular prescriptions.
- Understand how travel and out-of-area care are handled.
Using unbiased resources like the Medicare Plan Finder and speaking with a State Health Insurance Assistance Program (SHIP) counselor can help ensure your choice reflects both your health needs and your lifestyle, not just a plan’s marketing.
