What you pay in a Medicare Advantage Plan
- Whether the plan charges a monthly . Many Medicare Advantage Plans have a $0 premium. If you enroll in a plan that does charge 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).
- Whether the plan pays any of your monthly premium. Some plans will help pay all or part of your Part B premium. This is sometimes called a "Medicare Part B premium reduction."
- Whether the plan has a yearly or any additional deductibles.
- How much you pay for each visit or service ( or ). 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 .
- The type of health care services you need and how often you get them.
- Whether you go to a doctor or
- You're in a PPO, PFFS, or MSA plan.
- You go .
- Whether you follow the plan's rules, like using providers.
- Whether you need extra 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 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, and more that will be effective in January.
If you don't get these important documents, contact your plan. Get your plan's contact information.