What is the cost of a Medicare Advantage plan?
Medicare Advantage plans use a combination of deductibles, co-insurance and co-payments to share costs with you.
Each plan sets its own premium and decides on cost sharing terms. You need to look at the details of each plan you're considering to fully understand the costs. You can get specific information about plans you’re interested in from the companies offering them.
Plans are required to limit the amount you may have to pay out-of-pocket each year. The limit may vary by plan. In 2015, for example, the limit was $6,700 for the year, not counting premiums or drug costs.
Medicare Advantage Costs At a Glance
- Premiums for Medicare Advantage plans can vary widely. You continue to pay your Medicare Part B premium to Medicare (and your Part A premium, if you have one).
- Some plans charge an annual deductible, and some don't.
- Many plans charge co-payments for the services and benefits you use.
- Plans set their own co-insurance terms and percentages.
How does Medicare Advantage cost sharing work?
You will need to investigate the details of each plan to get the full story on its cost sharing. Plans vary widely, and their cost sharing usually works quite differently from the cost sharing used in Original Medicare (Parts A and B).
Cost-sharing terms and amounts vary from plan to plan. You'll need to shop around for a plan that best fits your needs.
Here are some examples. Your actual costs may be different.
Michael's story: Coordinated care in-network office visit
Maria's story: Brief hospital stay
William's story: Long hospital stay