Medicare Advantage plan Vs Medicare cost plan

If you receive Social Security payments, you may be automatically enrolled in Medicare Part A (hospital treatment) and Part B (disability coverage) (medical coverage). Original Medicare refers to Medicare Parts A and B. Original Medicare, on the other hand, is not the only way to acquire Medicare benefits. Medicare Advantage plans and Medicare Cost plans are two options for receiving Medicare benefits. The government administers Original Medicare, and commercial insurance companies contracted with Medicare administer Medicare Advantage plans and Medicare Cost plans.

What is the definition of a Medicare Advantage plan?

Medicare Advantage is also referred to as Medicare "Part C." Medicare Advantage is a commercial company that provides Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) instead of Original Medicare. Medicare Advantage plans frequently include coverage for Medicare Part D, prescription medications, which Original Medicare does not normally cover. Furthermore, Medicare Advantage plans frequently provide additional benefits not normally covered by Original Medicare, such as vision, hearing, and, in some cases, dentistry. You must keep paying your Medicare Part B premium. End-stage renal disease (ESRD) Medicare enrollees are typically unable to enrol in Medicare Advantage.

What exactly is a Medicare Cost Plan?

Medicare Cost Plans are Medicare health insurance plans that are only accessible in particular areas of the country. The availability of Medicare Cost Plans is determined by the insurance companies who sell them, rather than by Medicare. Medicare Cost Plans may provide coverage for prescription pharmaceuticals as well as other services not often covered by Original Medicare, such as hearing and vision coverage. End-stage renal disease (ESRD) Medicare enrollees are typically unable to participate in a Medicare Cost Plan.

What are the primary distinctions between a Medicare Advantage plan and a Medicare cost plan?

The table below highlights the key distinctions between a Medicare Advantage plan and a Medicare cost plan.

Do you have any other questions concerning Medicare coverage?

I'd be delighted to assist. If you prefer, you can have material prepared for you in an email or schedule a phone conversation at your leisure by clicking one of the buttons below. Click the “Compare Plans” button to check if Medicare Cost plans are available in your region, or to see which plans you may qualify for.

The product and service descriptions provided on these Medicare.com Web pages, if any, are not intended to be offers to sell or solicitations in connection with any product or service. All products are not available in every location and are subject to local laws, rules, and restrictions.

On January 1 of each year, benefits, premiums, and/or copayments/co-insurance] may vary.

Medicare Advantage plans include HMOs, PPOs, and HMOPOS plans.

You may be familiar with health plans such as health maintenance organisations (HMOs), preferred provider organisations (PPOs), and HMO point-of-service (POS) plans if you had group health insurance coverage through an employer or union plan. HMOs, PPOs*, and HMOPOS plans are other prominent types of Medicare Advantage plans. Aside from the plans you may be familiar with, there are other Medicare Advantage plans known as Medicare Special Needs Plans (SNPs). SNPs are intended to address the unique needs of particular Medicare recipients. If you have both Medicare and Medicaid coverage, reside in skilled nursing facilities or require skilled nursing care at home, or have any of the following chronic medical conditions, you may be eligible for a Medicare Special Needs Plan. Other types of Medicare Advantage plans are also available; however, availability and costs may vary.

You can acquire more precise information about Medicare Advantage plans available in your area by doing any of the following:

• On this page, click the Compare Plans or Find Plans tabs and input your zip code.

• You can also contact us if you want to talk about your Medicare coverage alternatives or if you need assistance comparing Medicare Advantage plans. To talk with one of our qualified insurance agents, please call the number listed on this page.

Except in emergency cases, out-of-network/non-contracted physicians are not required to treat Preferred Provider Organization (PPO) plan participants. We recommend you or your provider to request a pre-service organisation determination before receiving an out-of-network service to determine whether we will cover it. For more information, including the cost-sharing that applies to out-of-network services, please call our customer service hotline or consult your Evidence of Coverage.