Costs for Medicare Advantage Plans

What you pay in a Medicare Advantage Plan

Your 

out-of-pocket costs

 in a 

Medicare Advantage Plan (Part C)

 depend on:

  • Whether the plan charges a monthly premium .  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.
  • 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 ( copayment or 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 supplier who accepts assignment if:
    • You're in a PPO, PFFS, or MSA plan.
    • You go out-of-network .
  • Whether you follow the plan's rules, like using network providers.
  • 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.
Note

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:

If you don't get these important documents, contact your plan. Get your plan's contact information.

 

Find out who to call about Medicare options, claims and more.