I love to garden at home and at my church. My favorite part is picking out which seeds will work best with the sunlight, soil, and short Midwestern growing season.
Medicare plans are a bit like that, too. There are different types of plans available because everyone has different health care needs. That’s why it’s helpful to learn about all your Medicare options.
Want more coverage than Original Medicare?
Original Medicare includes Part A (hospital coverage) and Part B (doctor visits, outpatient care and supplies). But most people want more coverage.
People who enroll in Medicare can choose from different options to get that extra coverage, depending on the county where you live.
A Medicare Cost plan is one of those options. Cost plans include Original Medicare plus extra benefits and perks. You can choose a medical-only Cost plan and pair it with a separate Part D prescription drug plan for the right combination of coverage for you. Or, some Cost plans include Part D prescription drug benefits. Let’s highlight some reasons you might like this type of Medicare plan:
- You want to pay less for in-network doctor visits and other covered services
- You’re looking for a plan with a low monthly premium and no deductible
- You want protection with a plan that limits how much you pay each year out of pocket
- You want the flexibility to choose a Cost medical plan and a separate Part D plan
- You want more benefits than Original Medicare – some Medicare Cost plans offer benefits like gym memberships, routine hearing and vision exams, hearing aids, dental, acupuncture or chiropractic care
- You travel in the United States or worldwide and want coverage while you’re away
Compare Original Medicare and Medicare Cost plans
To help you understand a bit more about these plans, review the questions and answers below. Compare Medicare Cost to Original Medicare coverage and see if it’s the best fit for you.
| Original Medicare | Medicare Cost plan | |
|---|---|---|
|
Are you eligible? |
You’re eligible when you turn 65, are permanently disabled at any age, or have End-Stage Renal Disease. |
You must be enrolled in Medicare Part A and Part B, or Part B only. You also must live in a county where the plan is offered. |
|
When can you enroll? |
You have seven months to enroll when you first get Medicare. Enroll anytime during the three months before you turn 65, the month you turn 65, or the three months after you turn 65. You can sign up during the General Election Period between Jan. 1 – March 31 if you didn’t sign up when you were first eligible and are not eligible for a Special Enrollment Period. You may have other chances to sign up using a Special Enrollment Period. |
You have seven months to enroll when you first get Medicare. Enroll anytime during the three months before you turn age 65, the month you turn 65, or the three months after you turn 65. If you already have Medicare, you can enroll during the Annual Election Period Oct. 15 to Dec. 7 each year. If the Cost plan has a 5-Star rating, you can make a one-time switch from Dec. 8 to Nov. 30. You may have other chances to sign up using a Special Enrollment Period. |
|
How do monthly premiums work? |
Part B has a monthly premium based on income. Most people don’t pay a Part A premium. |
You pay your Medicare Part B monthly premium (and Part A premium if applicable). You pay a monthly premium for a Medicare Cost plan. Lower-premium plans are available depending on the type of coverage you want. |
|
What’s covered? |
Medicare Part A pays some costs for care from a hospital, skilled nursing facility, home health, or hospice. It has deductibles and copays. Medicare Part B pays some costs for doctor visits, lab tests, X-rays, outpatient care and medical supplies. It has an annual deductible and 20% coinsurance for covered care. |
Plans cover Medicare Parts A and B benefits with some cost sharing. They also cover some costs that Original Medicare doesn’t cover, like copays, coinsurance or deductibles. The plans usually have a limit on how much you pay each year. |
|
Is there prescription drug coverage? |
Original Medicare doesn’t cover Part D outpatient prescription medicines. If you want this coverage you would need to enroll in a separate Part D plan. |
Some Cost plans include Part D coverage for outpatient prescription medicine. If you choose a Cost plan with only medical coverage, you can enroll in a separate Part D plan for outpatient prescription medicines. You may be subject to a late enrollment penalty if you don’t enroll in a Part D plan when you are eligible. |
More about Medicare Cost plans
In addition, many Medicare Cost plans offer these features:
- Many Cost plans include coverage for a gym membership, routine eye and ear exams, and a U.S. travel benefit. You’ll get in-network benefits when you travel out of the plan’s service area for a limited period.
- Some plans offer coverage for hearing aids, acupuncture, chiropractic care or dental.
- Most plans have an out-of-pocket maximum so you get financial protection. This means you get peace of mind knowing there’s a limit on how much you pay each year for covered services.
- Medicare Cost plans usually have a network made up of a select group of doctors, clinics and hospitals. It’s always a good idea to check if your doctor is in the plan’s network. That’s because you usually pay less for covered services from a doctor or hospital in the network. If you choose to get care from a doctor that isn’t in the network, you’ll use your Original Medicare benefits and pay your share of the bill on your own.
- Medicare Cost plans usually have coverage for worldwide emergency or urgently needed care.