Medicare Advantage (Part C) Costs in 2022

• by Christian Worstell
• November 17, 2021
• Reviewed by John Krahnert

This article includes Medicare Advantage cost information for 2022. For updated costs related to other parts of Medicare, explore our Medicare Costs Guide.

Cost can be an important consideration when shopping for any type of health insurance.

Here’s what you should know about Medicare Part C (Medicare Advantage) costs in 2022, which can help you as you shop for Medicare Advantage plans in your area. 

Medicare Part C plan costs for 2022 were announced when new plans were offered for sale during the Medicare Annual Enrollment Period (AEP). It’s never too early to start planning for your potential Medicare costs for the coming year, such as premiums, deductibles and copayments.

Some Medicare Advantage plans may feature $0 premiums

Your Medicare Part C plan premium is the cost you must pay – typically monthly – to belong to the plan. 

In 2022, the average premium for a Medicare Part C plan is around $63 per month. This varied from plans with premiums as low as $38 per month in Maine and South Carolina to as high as over $100 per month in North and South Dakota, Massachusetts, Michigan and Rhode Island.¹

It’s important to note that many areas of the U.S. may feature $0 premium plans. In fact, over half of all beneficiaries of Medicare Advantage plans with prescription drug coverage (59 percent of beneficiaries) pay no premium for their plan.²

What affects Medicare Part C premiums?

Some variables that can affect the cost of a Medicare Part C premium include:

• Plan type
  There are several different types of Part C plans, each of which can vary in cost.
  
  For example, HMO (Health Maintenance Organization) plans tend to have lower premiums than PPO (Preferred Provider Organization) plans.
  
  
• Location
  Local market competition and cost-of-living can have an effect on the cost of a plan.
  
  For example, the average Medicare Advantage plan premium in South Carolina in 2022 is only $38 per month, while the same average premium in New York in 2022 is $71 per month.¹
  
  
• Coverage
  Some Medicare Part C plans can include a variety of extra benefits that aren’t covered by Original Medicare (Medicare Part A and Part B).
  
  Most Medicare Advantage plans cover prescription drugs, and some plans may offer coverage for dental and vision care, hearing care, fitness club memberships, non-emergency transportation and more.
  
  Plans that offer more extra benefits may cost a little more than plans that offer less coverage.
  
  
• Cost-sharing
  Some Part C plans may charge a higher premium but feature a lower deductible or coinsurance, while other plans may pair a lower premium with higher cost-sharing requirements.
  
  
• Insurance companies
  Each insurance company is free to set their own price for a Medicare Advantage plan. You may find two similar plans sold by two different companies in the same zip code, at very different prices. 
  
  A licensed insurance agent can help you compare plans that are available where you live in order to find the premium costs that fit your budget.

How Part C premiums compare to Original Medicare premiums

While most people do not pay a premium for Medicare Part A, beneficiaries typically pay the standard Part B premium, which is $170.10 per month in 2022.

People who report higher incomes may more for their Part B premiums, due to what is called the Medicare Income-Related Monthly Adjustment Amount (IRMAA).

Do Medicare Part C plans have deductibles?

A deductible is the amount you must pay out of your own pocket toward the costs of covered services and items before your plan coverage kicks in. Plans that include prescription drug coverage may have two separate deductibles: one for medical care costs and one for drug coverage costs.

Some Medicare Advantage plans may include $0 deductibles.

In 2022, the average drug deductible for Medicare Advantage plans is $301.94 per year. Medicare plan drug deductibles can be as high as $480 per year in 2022. 

In some states such as Illinois, the drug deductible can be around $400 or higher in 2022. On the other side of the spectrum, Utah's average Medicare plan drug deductible is $182.18. 

How Part C deductibles compare to Original Medicare deductibles

Medicare Part B requires an annual deductible of $233 for the year in 2022.

The 2022 Medicare Part A deductible is $1,556 per benefit period.  

Do Medicare Advantage plans have coinsurance or copays?

Cost-sharing measures are the share of medical bills that you must pay after your deductible has been met.

Cost-sharing can typically come in two forms:

• Copayments
  This is a flat-fee. A $20 copayment on a bill of $300 means you would pay $20 and your plan would cover the remaining $280.
  
  
• Coinsurance
  Coinsurance is a percentage of your medical bill. A 20 percent coinsurance requirement on a $300 bill means you’ll pay $60 (20 percent of $300), while your plan takes care of the remaining $240.

Cost-sharing such as coinsurance and copays with Medicare Part C plans may vary by plan. 

How Part C cost-sharing compares to Original Medicare copays/coinsurance

Part B of Medicare typically requires a 20 percent coinsurance payment for covered services and items (after you meet your Part B deductible).

Part A coinsurance could reach as high as $778 per day in 2022 for extended inpatient hospital stays.

Medicare Advantage plans include out-of-pocket spending limits

A Medicare Advantage plan out-of-pocket spending limit represents an annual cap on your out-of-pocket spending for covered Part A and Part B health care costs.

Once you have reached this amount, your Part C plan will pay for 100 percent of the cost of all covered services and items for the remainder of the year. 

By law, all Part C plans must contain an out-of-pocket limit of no more than $7,550 in 2022, though some plans may feature lower limits.

The out-of-pocket limit can help protect you from Medicare out-of-pocket costs that can add up quickly as a result from a serious injury or illness that requires lengthy inpatient hospital stays.

Original Medicare does not feature an out-of-pocket limit, which can be one factor many beneficiaries may consider in joining a Medicare Advantage plan.

Compare Medicare Part C costs where you live

If you have questions about Medicare Part C costs or would like to compare Part C plans available in your area, call to speak with a licensed insurance agent today. 

¹ MedicareAdvantage.com's internal analysis of CMS Medicare Advantage landscape source files, Nov. 2021. Data retrieved from www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovGenIn.

² Freed M, et al. (Nov. 2, 2021). Medicare Advantage 2022 Spotlight: First Look. Kaiser Family Foundation. https://www.kff.org/medicare/issue-brief/medicare-advantage-2022-spotlight-first-look.

About the author

Christian Worstell is a senior Medicare and health insurance writer with MedicareAdvantage.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.

Christian’s work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.

Christian has written hundreds of articles for MedicareAvantage.com that teach Medicare beneficiaries the best practices for navigating Medicare. His articles are read by thousands of older Americans each month. By better understanding their health care coverage, readers may hopefully learn how to limit their out-of-pocket Medicare spending and access quality medical care.

Christian’s passion for his role stems from his desire to make a difference in the senior community. He strongly believes that the more beneficiaries know about their Medicare coverage, the better their overall health and wellness is as a result.

A current resident of Raleigh, Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism.

If you’re a member of the media looking to connect with Christian, please don’t hesitate to email our public relations team at Mike@tzhealthmedia.com.

 

 

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