There's a reason many older Americans opt to sign up for a Medicare Advantage plan instead of sticking with original Medicare. Medicare Advantage plans commonly offer benefits beyond what original Medicare covers, like dental cleaning, eye exams, and hearing aids.
Plus, with Medicare Advantage, you get the benefit of having an annual limit on your out-of-pocket costs. When you're on a fixed income of Social Security and, if you're lucky, withdrawals from a retirement account, that's important.
Image source: Getty Images.
But if you're new to Medicare Advantage, you should know that it works differently than original Medicare. And there may be some hidden quirks you didn't realize. Here's what you need to know if you're using Medicare Advantage for the first time in 2026.
1. You're not off the hook from paying for Part B
Many seniors find that their costs are lower under Medicare Advantage than original Medicare, especially since a good number of Advantage plans offer $0 premiums. But one thing you should know is that if you're enrolled in Medicare Advantage, you still have to pay your premium for Part B.
Your Part B premium is a separate mandatory cost to stay enrolled in Medicare, regardless of whether you stick to original Medicare or choose an Advantage plan. If you're on Social Security, that Part B premium is generally deducted from your monthly benefits. If you're not collecting those benefits yet, you'll get a bill for Part B.
2. You need to pay attention to your plan's network
If you've used original Medicare in the past, you may be used to having a pretty wide network of providers to choose from. As a Medicare Advantage enrollee, you may face some challenges once you realize that you're limited to a pretty specific provider network.
Of course, some Medicare Advantage plans offer more generous networks than others. The providers you have access to will hinge on your plan and location.
But it's important to try to stay within your Medicare Advantage plan's network. Going outside it could mean incurring very expensive costs due to your plan not paying.
3. You're not stuck with your plan all year long if it's not working out
If you're nervous about taking a chance on Medicare Advantage, you have some protection in case you don’t end up liking your plan. Each, there's a Medicare Advantage open enrollment period that runs from Jan 1. through Mar 31. This period is for Medicare Advantage enrollees only, and what it lets you do is switch your coverage so you're not stuck with a sub-optimal plan all year.
Specifically, during Medicare Advantage's open enrollment period, you can move off of the plan you've chosen and pick a new Advantage plan, or you can drop Medicare Advantage and move back to original Medicare. From there, you'll be able to enroll in a Part D drug plan, which you’ll need on top of Parts A and B.
You may want to look into a new Medicare Advantage plan if you find that you're not happy with your provider network, or if you're not able to take advantage of the extra benefits your plan offers. Or, you may decide to switch plans if your costs are coming in higher than expected.
Just know that during Medicare Advantage's open enrollment period, you can only make one change to your coverage. You can’t pick up a new Advantage plan in February and then move to a different one in March.
Medicare Advantage can, for many people, be a cost-effective alternative to original Medicare. But it's important to know what to expect in the coming year. That means not only being mindful of the points above, but reading through your plan's rules carefully so you understand how your coverage works.
