Understanding health plan costs

Your costs will vary based on several factors such as the plan you join and what services you get. Get specific cost information about a plan you’re interested in.

Things to considerAnswer
If the plan charges a monthly premium

If you join a plan that charges a premium, you pay this in addition to the Part B premium (and the Part A premium if you don't have premium-free Part A ).

Note: Some plans will help pay all or part of your Part B premium, but this isn’t available in all areas. This is sometimes called a "Medicare Part B premium reduction." Contact the plan for more information.

If the plan has a yearly deductible and copayment These amounts can be different from those under Original Medicare. Each year, plans set the amounts they charge for premiums, deductibles, and services. The plan (rather than Medicare) decides how much you pay for the covered services you get. What you pay the plan can only change once a year, on January 1.
If your doctor, provider, or supplier accepts assignment

If your doctor, provider, or supplier accepts assignment:

  • Your out-of-pocket costs may be less.
  • They agree to charge you only the Medicare deductible and coinsurance amount and usually wait for Medicare to pay its share before asking you to pay your share.
  • They have to submit your claim directly to Medicare and can’t charge you for submitting the claim.
Other factors that might affect what you pay
  • Whether you follow the plan's rules, like using in-network providers.
  • If the plan offers extra benefits and what they charge for them.
  • The plan's yearly limit on your out-of-pocket costs for all medical services.
  • Whether you have Medicaid or get help from your state.
  • The type of plan you have.
  • The services you need and how often you get them.
  • If have other health coverage. Find out how Medicare works when you have more than one kind of health coverage.

Contact any plans you're interested in to get more details.