Other Medicare health plans

Other Medicare health plans have some of the same rules as Medicare Advantage Plans (Part C) . However, each type of plan has special rules and exceptions, so it’s important to contact the plan you're interested in for more details. Learn about rules Medicare plans must follow when they contact you.

Medicare Cost Plans

Cost Plans are only available in certain, limited areas of the country. Find out if a Cost Plan is available in your area.

How do people with Cost Plans get services?

If you have a Cost Plan, you may get services from the plan’s network of providers at a lower cost. You may also use providers who accept Medicare, and you’ll pay Original Medicare costs.

Generally, you can join a Cost Plan whenever the plan is accepting new members, even if you only have Part B. You can leave a Cost Plan at any time and return to Original Medicare.

How do Cost Plans handle drug coverage?

You can join a separate Medicare drug plan, or you can get drug coverage from the Cost Plan (if it’s offered).
Even if the Cost Plan offers drug coverage, you can choose to get drug coverage from a separate Medicare drug plan.
You can only add or drop Medicare drug coverage at certain times.

Health Care Prepayment Plans (Part B-only Cost Plans)
There’s another type of Medicare Cost Plan called a Health Care Prepayment Plan (HCPP) that only provides coverage for Part B services (your Part A services are covered through Original Medicare). These plans are either sponsored by employer or union group health plans or offered by companies that don't provide Part A services. These plans never include Part D. Contact the plan for more information.

Demonstrations & pilot programs

Demonstrations and pilot programs (also called “research studies”) are special projects that test improvements in Medicare coverage, payment, and quality of care. They’re usually only available for a limited time, for a specific group of people, or are offered only in specific areas. Check with the demonstration or pilot program you’re interested in to find out how it works. Examples of current demonstrations and pilot projects include innovations in primary care, care related to specific procedures (like hip and knee replacements), cancer care, skilled nursing facility care or rehabilitation care, and care for people with chronic kidney disease and End-Stage Renal Disease (ESRD). Medicare also explores innovations through Accountable Care Organizations (ACOs). To learn about current Medicare demonstrations and pilot programs, call us at 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.

Program of All-Inclusive Care for the Elderly (PACE)

PACE (Program of All-inclusive Care for the Elderly) is a Medicare-Medicaid program that helps people meet health care needs in the community.

Learn more about PACE.