Introduction to Medicare
Cost Basics
[[state-start:null,FL,GU,ID,IL,IN,MD,MO,NH,NJ,NY,OH,OR,PA,TX,VA]]
Medicare isn’t free. And it’s important to pay attention to more than just monthly premiums. The amount you’ll pay depends on the coverage you choose and the health care services you receive. And don’t forget to see if you may qualify for help with your Medicare costs.
[[state-end]]
[[state-start:AL,AK,AS,AZ,AR,CA,CO,CT,DE,GA,HI,IA,KS,KY,LA,ME,MA,MI,MN,MS,MT,MP,NE,NV,NM,NC,ND,OK,PR,RI,SC,SD,TN,UT,VT,VI,WA,DC,WV,WI,WY]]
It’s important to pay attention to more than just monthly Medicare premiums. The amount you’ll pay depends on the coverage you choose and the health care services you receive. And don’t forget to see if you may qualify for help with your Medicare costs.
[[state-end]]
[[state-start:AL,AK,AS,AZ,AR,CA,CO,CT,DE,GA,HI,IA,KS,KY,LA,ME,MA,MI,MN,MS,MT,MP,NE,NV,NM,NC,ND,OK,PR,RI,SC,SD,TN,UT,VT,VI,WA,DC,WV,WI,WY]]
What is a premium?
Which costs might I share with Medicare or my plan?
Are there plans that limit out-of-pocket spending each year?
What costs can I expect for 2020?
What if I need help paying Medicare costs?
[[state-end]]
Deductible:
This is a set amount that you pay out of pocket for covered services before Medicare, your Medicare Advantage and/or Prescription Drug plan start to pay.
-
You Pay First Up to the Limit
-
Medicare and/or Your Plan Begins to Pay
[[state-start:AL,AK,AZ,AR,CA,CO,CT,DE,FL,GA,GU,HI,ID,IL,IN,IA,KS,KY,LA,ME,MD,MA,MI,MN,MS,MO,MT,MP,NE,NV,NJ,NM,NY,NC,ND,OH,OK,OR,PA,PR,RI,SC,SD,TN,TX,UT,VT,VI,VA,WA,DC,WV,WI,WY]]
Depending on the Medicare Supplement insurance plan chosen, this is the amount your plan may help pay after Medicare pays.
[[state-end]]
Copayment (copay):
A fixed amount that you pay each time you receive a covered service. For example, if you have prescription drug coverage, you might pay $10 each time you fill a certain prescription.
-
You Pay a Fixed Amount
-
Medicare Advantage or Prescription Drug Plans: They will be billed for the rest
Coinsurance:
An amount you may be required to pay as your share for the cost of a covered service. For example, Medicare Part B pays about 80% of the cost of a covered medical service and you would pay the rest.
[[state-start:AL,AK,AS,AZ,AR,CA,CO,CT,DE,GA,HI,IA,KS,KY,LA,ME,MA,MI,MN,MS,MT,MP,NE,NV,NM,NC,ND,OK,PR,RI,SC,SD,TN,UT,VT,VI,WA,DC,WV,WI,WY]]
[[state-end]]
Are there plans that limit out-of-pocket spending each year?
It depends on which type of coverage you have.
Original Medicare (Parts A and B):
No.
Medicare Advantage (Part C) plans:
Yes. After you reach the annual out-of-pocket maximum, your plan will pay all your costs for Medicare-covered services for the rest of the period (usually a calendar year). Costs that do not apply to the annual out-of-pocket maximum include premiums, Part D prescription drugs, and extra benefits that are not covered by Original Medicare.
Medicare Prescription Drug (Part D) plans:
No. But the amount you will pay for your prescription drugs depends on the drug payment stage you’re in:
Drug Payment Stages:
| Stage 1: Annual Deductible |
|
|---|---|
| Stage 2: Initial Coverage |
|
| Stage 3: Coverage Gap (also called “Donut Hole”) |
|
| Stage 4: Catastrophic Coverage |
|
Medicare Supplement insurance plans (Medigap):
[[state-start:null,AL,AK,AS,AZ,AR,CA,CO,CT,DE,GA,GU,HI,ID,IL,IN,IA,KS,KY,LA,ME,MD,MA,MI,MN,MS,MO,MT,MP,NE,NV,NH,NJ,NM,NY,NC,ND,OH,OK,OR,PA,PR,RI,SC,SD,TN,TX,UT,VT,VI,VA,WA,DC,WV,WI,WY]]Medigap plans help pay for some of the out-of-pocket costs Medicare doesn’t pay. Most Medigap plans don’t have a yearly maximum out-of-pocket limit; two plans currently do. For Plans K and L, after you meet your out -of-pocket yearly limit and your yearly Part B deductible ($185 in 2019), the Medigap plan pays 100% of covered services for the rest of the calendar year. [[state-end]]
[[state-start:FL]]Two Medicare supplement plans currently do have an out-of-pocket spending limit. For Medicare supplement plans K and L, once the annual out -of -pocket maximum amount and Part B deductible is met, these plans pay 100% of the Medicare co-payment and coinsurance for the rest of the calendar year. Costs that do not apply to the annual out -of -pocket maximum include premiums, charges from your provider that exceed Medicare-approved amounts (called "Excess Charges") and services not covered by Original Medicare. [[state-end]]
[[state-start:AL,AK,AZ,AR,CA,CO,CT,DE,FL,GA,GU,HI,ID,IL,IN,IA,KS,KY,LA,ME,MD,MA,MI,MN,MS,MO,MT,MP,NE,NV,NJ,NM,NY,NC,ND,OH,OK,OR,PA,PR,RI,SC,SD,TN,TX,UT,VT,VI,VA,WA,DC,WV,WI,WY]]
Learn more about drug payment stages and the coverage gap
[[state-start:AL,AK,AS,AZ,AR,CA,CO,CT,DE,GA,HI,IA,KS,KY,LA,ME,MA,MI,MN,MS,MT,MP,NE,NV,NM,NC,ND,OK,PR,RI,SC,SD,TN,UT,VT,VI,WA,DC,WV,WI,WY]]
[[state-end]]
What costs can I expect for 2020?
Depending on which type of coverage you have, your costs may be different.
Original Medicare:
To get an idea of 2020 costs, you can visit Medicare 2020 costs at a glance on the Medicare.gov website.
[[state-start:AL,AK,AZ,AR,CA,CO,CT,DE,FL,GA,GU,HI,ID,IL,IN,IA,KS,KY,LA,ME,MD,MA,MI,MN,MS,MO,MT,MP,NE,NV,NJ,NM,NY,NC,ND,OH,OK,OR,PA,PR,RI,SC,SD,TN,TX,UT,VT,VI,VA,WA,DC,WV,WI,WY]]
Medicare Advantage, Medicare Supplement insurance or Medicare Prescription drug plans:
To get an idea of the out-of-pocket costs for each plan offered by UnitedHealthcare, you’ll want to check to see which plans are offered in your area.
[[state-end]]
[[state-start:null,AS,NH]]
Medicare Advantage or Medicare Prescription drug plans:
To get an idea of the out-of-pocket costs for each plan offered by UnitedHealthcare, you’ll want to check to see which plans are offered in your area.
[[state-end]]
[[state-start:null,FL,GU,ID,IL,IN,MD,MO,NH,NJ,NY,OH,OR,PA,TX,VA]]
What if I need help paying Medicare costs?
You may be eligible for financial assistance to cover your health care expenses—many people who could qualify never sign up. So don’t hesitate to apply. Income and resource limits vary by program.
Medicaid:
Provides health care coverage for people and families with limited incomes. It may also include some services not covered by Medicare, like prescription drugs, eye care or long-term care.
Medicare Savings Programs:
Help pay Original Medicare (Parts A and B) premiums, deductibles, and coinsurance. You automatically qualify for the Extra Help program (see below) if you qualify for a Medicare Savings Program.
Programs of All-Inclusive Care for the Elderly (PACE):
Combine medical, social and long-term care services for people over the age of 55 who qualify. This program is not available in all states.
Extra Help program:
Helps pay some or all Medicare Part D premiums, deductibles, copays and coinsurance for those who qualify.
[[state-end]]
[[state-start:AL,AK,AS,AZ,AR,CA,CO,CT,DE,GA,HI,IA,KS,KY,LA,ME,MA,MI,MN,MS,MT,MP,NE,NV,NM,NC,ND,OK,PR,RI,SC,SD,TN,UT,VT,VI,WA,DC,WV,WI,WY]]
[[state-end]]
[[state-start:AL,AK,AS,AZ,AR,CA,CO,CT,DE,GA,HI,IA,KS,KY,LA,ME,MA,MI,MN,MS,MT,MP,NE,NV,NJ,NC,ND,OK,PR,RI,SC,SD,TN,UT,VT,VI,WA,DC,WV,WI,WY]]
What if I need help paying Medicare costs?
You may be eligible for financial assistance to cover your health care expenses—many people who could qualify never sign up. So don’t hesitate to apply. Income and resource limits vary by program.
Extra Help program:
Helps pay some or all Medicare Part D premiums, deductibles, copays and coinsurance for those who qualify.
Learn how to get help with prescription drug costs
Medicaid:
Provides health care coverage for people and families with limited incomes. It may also include some services not covered by Medicare, like prescription drugs, eye care or long-term care.
Medicare Savings Programs:
Help pay Original Medicare (Parts A and B) premiums, deductibles, and coinsurance. You automatically qualify for the Extra Help program (see below) if you qualify for a Medicare Savings Program.
Programs of All-Inclusive Care for the Elderly (PACE):
Combine medical, social and long-term care services for people over the age of 55 who qualify. This program is not available in all states.
[[state-end]]
[[state-start:CT,PR]]
Medicare Supplement insurance plans:
Medigap plans help pay for some of the out-of-pocket costs Medicare doesn’t pay. Most Medigap plans don’t have a yearly maximum out-of-pocket limit; two plans currently do.
[[state-end]]
[[state-start:AL,AK,AS,AZ,AR,CA,CO,CT,DE,GA,HI,IA,KS,KY,LA,ME,MA,MI,MN,MS,MT,MP,NE,NV,NM,NC,ND,OK,PR,RI,SC,SD,TN,UT,VT,VI,WA,DC,WV,WI,WY]]
[[state-end]]
See UnitedHealthcare Plans Available In Your Area
Explore the Medicare Advantage, Medicare Prescription Drug and Medicare Supplement insurance plans that may be available in your area. Or learn if you qualify for a Medicare Special Needs Plan.
Still have questions?
Give Us a Call
Call UnitedHealthcare: 1-855-264-3796 (TTY 711)
Hours: 8 a.m. – 8 p.m., 7 days a week*
Call UnitedHealthcare: 1-855-265-1557 (TTY 711)
Hours: 8 a.m. – 8 p.m., 7 days a week*
* In Alaska and Hawaii, 8 a.m. – 8 p.m. Monday – Friday, 8 a.m. – 5 p.m. Saturday – Sunday.
Chat with Us Online
Chat live with a licensed sales agent/producer.
Note: You need to allow pop-ups in your browser to use chat.
Meet with a Licensed Insurance Agent/Producer
Make an appointment for Medicare Advantage or Prescription Drug plans
[[state-start:AL,AZ,AR,CA,CO,CT,DE,FL,GA,HI,ID,IL,IN,IA,KS,KY,LA,ME,MD,MA,MI,MN,MS,MO,NE,NV,NJ,NM,NY,NC,ND,OH,OK,OR,PA,RI,SC,SD,TN,TX,UT,VT,VI,VA,WA,DC,WV,WI]]
Make an appointment for Medicare Supplement Insurance plans
[[state-end]]
View Important Disclosures Below
United Healthcare Insurance Company pays royalty fees to AARP for the use of its intellectual property. These fees are used for the general purposes of AARP. AARP and its affiliates are not insurers. AARP does not employ or endorse agents, brokers or producers.
AARP® encourages you to consider your needs when selecting products and does not make specific product recommendations for individuals.
Please note that each insurer has sole financial responsibility for its products.
AARP® Medicare Supplement Insurance Plans
Insured by UnitedHealthcare Insurance Company, Horsham, PA[[state-start:null,AL,AK,AS,AZ,AR,CA,CO,CT,DE,GA,GU,HI,ID,IL,IN,IA,KS,KY,LA,ME,MD,MA,MI,MN,MS,MO,MT,MP,NE,NV,NH,NJ,NM,NY,NC,ND,OH,OK,OR,PA,PR,RI,SC,SD,TN,TX,UT,VT,VI,VA,WA,DC,WV,WI,WY]] (UnitedHealthcare Insurance Company of New York, Islandia, NY for New York residents) [[state-end]]. Policy form No. GRP 79171 GPS-1 (G-36000-4).
[[state-start:null,AL,AK,AS,AZ,AR,CA,CO,CT,DE,GA,GU,HI,ID,IL,IN,IA,KS,KY,LA,ME,MD,MA,MI,MN,MS,MO,MT,MP,NE,NV,NH,NJ,NM,NY,NC,ND,OH,OK,OR,PA,PR,RI,SC,SD,TN,TX,UT,VT,VI,VA,WA,DC,WV,WI,WY]]In some states, plans [[state-end]] [[state-start:FL]]Plans [[state-end]] may be available to persons under age 65 who are eligible for Medicare by reason of disability or End-Stage Renal Disease.
Not connected with or endorsed by the U.S. Government or the federal Medicare program.
This is a solicitation of insurance. A licensed insurance agent/producer may contact you.
You must be an AARP member to enroll in an AARP Medicare Supplement Plan.
THESE PLANS HAVE ELIGIBILITY REQUIREMENTS, EXCLUSIONS AND LIMITATIONS. FOR COSTS AND COMPLETE DETAILS (INCLUDING OUTLINES OF COVERAGE), CALL A LICENSED INSURANCE AGENT/PRODUCER AT THE TOLL-FREE NUMBER ABOVE.
Medicare Advantage plans and Medicare Prescription Drug plans
Plans are insured through United Healthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a Medicare-approved Part D sponsor. Enrollment in these plans depends on the plan's contract renewal with Medicare.
You must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third party.
The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premium and/or copayments/ coinsurance may change on January 1 of each year.