What you pay in a Medicare Advantage Plan
- Whether the plan charges a monthly
Premium. Some plans have no premium.
- Whether the plan pays any of your monthly
Medicare Part B (Medical Insurance)premium. Some plans pay all or part of your Part B premium.
- Whether the plan has a yearly
Deductible [glossary]or any additional deductibles.
- How much you pay for each visit or service (
Copaymentor Coinsurance). For example, the plan may charge a copayment, like $10 or $20 every time you see a doctor. These amounts can be different than those under Original Medicare.
- The type of health care services you need and how often you get them.
- Whether you go to a doctor or
Supplierwho accepts Assignmentif:
- You're in a PPO, PFFS, or MSA plan.
- You go
- Whether you follow the plan's rules, like using
- Whether you need extra
Benefits [Glossary]and if the plan charges for it.
- The plan's yearly limit on your out-of-pocket costs for all medical services.
- Whether you have
Medicaid [Glossary]or get help from your state.
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 may change only once a year, on January 1.
Get more cost details from your plan
If you're in a Medicare plan, review these notices your plan sends you each fall:
- "Evidence of Coverage" (EOC). The EOC gives you details about what the plan covers, how much you pay, and more.
- "Annual Notice of Change" (ANOC). The ANOC includes any changes in coverage, costs, or service area that will be effective in January.