How Much Does Medicare Advantage Cost?

Cost is one of the most common questions seniors have about Medicare Advantage — and the answer is more nuanced than a single number. Your total Medicare Advantage costs depend on which plan you choose, where you live, what healthcare you use, and whether you qualify for any low-income subsidies. Here is a breakdown of what you can expect.

Monthly premiums

Many Medicare Advantage plans have $0 monthly premiums, meaning you pay nothing beyond your standard Medicare Part B premium (approximately $185 per month in 2026, deducted automatically from your Social Security payment). Some plans do charge a separate monthly premium on top of Part B, typically ranging from $10 to $100 or more depending on the plan's richness of benefits. Plans with richer dental, vision, and drug coverage sometimes charge a modest premium.

Copays and coinsurance

Even on a $0-premium plan, you will typically pay copays when you use services. A primary care visit might be $0 to $10. A specialist visit is often $35 to $50. Emergency room visits are usually higher. These amounts vary plan by plan. The good news is that Medicare Advantage plans have an annual out-of-pocket maximum — once you hit that limit (often between $3,000 and $8,300 in-network), the plan covers 100% of covered costs for the rest of the year. Original Medicare has no such cap.

Drug coverage costs

Most Medicare Advantage plans bundle prescription drug coverage (Part D) into the plan. You will pay a drug tier copay each time you fill a prescription. Tier 1 generics are often $0 to $5. Higher-tier branded drugs can be significantly more. If you take several medications, it is critical that a licensed agent checks your specific drugs against each plan's formulary before you enroll.

Extra help and low-income subsidies

If your income and assets are below certain limits, you may qualify for the Low Income Subsidy (LIS), also called Extra Help, which reduces or eliminates Part D drug costs. You may also qualify for a Dual Eligible Special Needs Plan (D-SNP) if you have both Medicare and Medicaid, which can reduce your out-of-pocket costs to near zero. A licensed agent can determine whether you qualify for any of these programs.

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