Medicare Advantage Explained: Part C, HMO vs PPO and the $0 Premium Myth (2026)

Medicare Advantage — Medicare Part C — is the most heavily advertised part of Medicare and the least well understood. David Heitner walks through how Part C actually works: what "$0 premium" really means, how you pay as you use care, the annual out-of-pocket limit, HMO versus PPO, prior authorization, and the one question you have to ask about your own doctors before you enroll. In this video: 0:00 - What Medicare Advantage is 1:06 - How Part C actually works 2:06 - Why "$0 premium" is not $0 2:49 - How you pay for care 3:39 - The annual out-of-pocket limit 4:37 - HMO or PPO 5:39 - Check your doctors, don't assume 6:22 - Prior authorization 7:04 - Prescription drug coverage 7:52 - The extra benefits, in the right order 8:58 - What happens when you travel 9:55 - Your plan can change every year 10:45 - Why Medigap and Advantage are not used together 11:27 - Which one is better? 12:14 - Where we go from here This is Episode 5 of an ongoing series. Episode 1 covers the foundation, Episode 2 goes deeper on Part A, Episode 3 covers Part B, and Episode 4 covers Medicare Supplement insurance. Episode 6 puts the two paths side by side. Key points from this video: Medicare Advantage is another way to receive your Part A and Part B benefits, through a Medicare-approved private plan You must stay enrolled in Parts A and B, and you generally still pay your Part B premium Most Medicare Advantage plans include Part D prescription drug coverage Medicare Advantage plans have an annual limit on what you pay out of pocket for covered Part A and Part B services; Original Medicare by itself does not A doctor who accepts Original Medicare is not automatically in a given Medicare Advantage plan's network A Medicare Supplement policy is not used to pay Medicare Advantage copayments and deductibles FREE GUIDE - Medicare Insurance Basics (PDF): https://drive.google.com/file/d/1GHbM... More Medicare resources: https://heitsbenefits.com/medicare/?u... Questions about your own situation: Call or text (201) 647-2095. Heits Benefits Group does not offer every plan available in your area. Any information provided is limited to the plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. Not connected with or endorsed by the U.S. Government or the federal Medicare program. David Heitner, National Producer Number 2098121 #Medicare #MedicareAdvantage #MedicarePartC #Medicare2026 #HMOvsPPO #TurningSixtyFive #MedicareExplained #HeitsBenefits Securities and advisory services offered through Independent Financial Group, LLC (IFG), a Registered Investment Adviser. Member FINRA/SIPC. Heits Benefits Group and IFG are unaffiliated entities. OSJ Branch: 12671 High Bluff Dr. Suite 200. San Diego, CA 92130 IFG Registered Representatives associated with this website may discuss and/or transact business only with residents of the states in which they are properly registered or licensed. Some insurance products are offered outside of the existing Broker Dealer relationship. The information provided is from sources believed to be reliable however, we cannot guarantee or represent that it is accurate or complete. Because situations vary, any information provided on this site is not intended to indicate suitability for any investor. Hyperlinks are provided as a courtesy and should not be deemed as an endorsement. When you link to a third-party website you are leaving our site and assume total responsibility for your use or activity on the third-party sites.