Medicare Cost Plans, Medicare Advantage (Part C) Plans and Medigap (Medicare Supplemental Insurance) Plans are all options you should know about. Find out how these plans differ and which plan might offer the choices you want.
Medicare Cost Plans
Medicare Cost Plans are a type of Medicare health plan offered by private companies, such as Medica, that are available in certain areas of the country. They cover Original Medicare services and may offer benefits such as vision or hearing coverage or prescription drug coverage. You can join a Cost Plan any time that plan is accepting new members (you do not have to wait until AEP), and you can leave anytime and return to Original Medicare. However, if your Cost Plan contains Part D (prescription drug) coverage, you won’t be able to maintain your Part D coverage when you return to Original Medicare.
Medicare Advantage Plans (Part C)
Medicare Advantage Plans are offered by private companies, like Medica, and are approved by Medicare — so these companies follow rules set by Medicare. Medicare Advantage plans may offer extra coverage, such as vision, hearing, dental, and/or health and wellness programs. And most include Medicare prescription drug coverage (Part D). In addition to your Part B premium, you usually pay a monthly premium for the services included in a Medicare Advantage Plan.
Medicare Advantage Plans cover all of the services offered by Original Medicare, plus you’re always covered for emergency and urgent care. The one exception is that Original Medicare covers hospice care, even if you’re in a Medicare Advantage Plan.
Each Medicare Advantage Plan charges different out-of-pocket costs and have different rules for how you get services (like whether you need a referral to see a specialist or if you have to go to only doctors, facilities, or suppliers that belong to the plan for non‑emergency or non‑urgent care).
Medigap Policies (Medicare Supplement Insurance)
Original Medicare pays for many, but not all, health care services and supplies. A Medigap policy, sold by private insurance companies, can help pay some of the health care costs (gaps) in Original Medicare — like copayments, coinsurance and deductibles. Medigap policies can also offer coverage for services that Original Medicare doesn’t cover, like medical care when you travel outside the U.S.
With a Medigap policy, Medicare pays its share of the Medicare-approved amount for covered health care costs, and then your Medigap policy pays its share. All plans offer the same basic benefits but some offer additional benefits, so you can choose which one meets your needs. Go to www.Medicare.gov to find out more.