C-Suite Cheat Sheet: Medicare Part C (Medicare Advantage)

Educational briefing for suppliers and service providers

Executive summary

Medicare Advantage (MA), also known as Medicare Part C, is a type of insurance plan funded by the Centers for Medicare and Medicaid Services (CMS) but administered by a private payer. MA plans cover all traditional Medicare benefits (Parts A and B) and many include prescription drug benefits (Part D) as well.

MA plans are gaining popularity among both enrollees and providers. Between 2005 and 2015, the number of beneficiaries enrolled in MA plans tripled from 5.6 million to 16.8 million. By 2025, experts expect about 30 million, or about 40% of Medicare beneficiaries, to be enrolled in MA plans. While MA plans have historically been offered by commercial insurers, a growing number of health care providers are taking advantage of the expanding MA market either by negotiating a stake in existing plans or sponsoring their own plans.

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