Medicare Advantage Plan Costs

What does Medicare Advantage Plan Cost?

All Medicare Advantage Plans will cost different amounts depending on how often you use their services and whether or not you follow the plan's rules for services. If you don't follow the plan's rules the plan can cost significantly more than if you do.

Here are some basic questions that you will want answered when you are looking at comparing the costs of various Advantage Plans:

  • Does the Plan include Part D, Prescription Drug coverage? If it doesn't you may need to factor in the costs of a Part D Plan.
  • Can the Plan be used with your other retiree benefits? If it CAN this means that your out-of-pocket expenses should be lower. Check with both your retiree plan and the Advantage Plan to make sure this is the case. If possible get confirmation in writing from both plans and a list of rules that applies to who pays first in various types of situations.
  • Does the Advantage Plan charge a monthly premium? Does this premium include any of the Part B premiums?
  • What are the standard co-payments for the plan?
  • What is the yearly deductible for the plan?
  • Are there any additional deductibles?
  • What is the yearly limit on out-of-pocket expenses? What is their definition of out-of-pocket expenses? Is anything excluded?
  • What does the plan pay if you see a non-preferred provider?
  • What happens if you are traveling and are forced to use an out of area provider? How much will the plan pay?

Auntie Lou says, "Could there be any more variables? Oh come on, there must be a better way."

The costs of each Advantage Plan can be more or less than Original Medicare depending on each individual's situation. If possible add up what you are currently paying for Original Medicare and compare the services that you use most often. In addition if you know a large medical bill is likely to occur in the future (knee surgery for example) look closely at the costs and providers and figure out exactly what your Advantage Medicare Plan is likely to pay compared to Original Medicare. Extra Help is also available for individuals that are worried about meeting their Medicare obligations. Call 1-800-MEDICARE (1-800-633-4227) TTY Users: 1-877-486-2048 and ask to speak to a representative about getting Extra Help.