September 17, 2014
As a Medicare beneficiary, it's important for you to understand a few key concepts related to the pricing considerations of Medicare Advantage (Medicare Part C) plans. Monthly premiums vary considerably among Medicare Advantage plans, so you'll want to do some research to make an informed enrollment decision when choosing the insurance plan that best suits your needs.
What does a Medicare Advantage premium cover?
There may be many Medicare Advantage plans from various health insurance companies in your area. You may want to assess estimated annual costs (including copayments, coinsurance, deductibles, and monthly premiums) for each plan available in your area, while taking into consideration the prescription drugs you require on a regular basis.
If you have a limited income and limited resources, you may be eligible for Extra Help. The Extra Help program pays for your prescription drug coverage costs, either partially or in full. You can apply online at www.socialsecurity.gov/extrahelp or call Social Security at 1-800-772-1213 (TTY users 1-800-325-0778). Social Security representatives are available Monday through Friday, from 7AM to 7PM.
What costs do Medicare Advantage plans have?
Remember that a Medicare Advantage plan may have more costs than its monthly premiums alone. Beneficiaries may have copayments, coinsurance, and deductibles associated with doctors' visits, hospital stays, and other health-care services. Beneficiaries also have out-of-pocket expenses associated with medications, including deductibles and copayments. In general, Medicare Advantage plans have a maximum allowable deductible that they can charge, but they also have the option to reduce or eliminate this deductible.
Also remember that copayments for the same medication
may be different among the various Medicare Advantage plans. Consequently, it is always advisable to compare the annual estimated costs among Medicare Advantage health insurance plans based on your normal monthly prescription drug purchases. By including all plan costs, and not just the premium, you can make a more educated decision when choosing a Medicare Advantage plan.
Compare Medicare Advantage plans
To make an informed decision when choosing a Medicare Advantage plan, it is suggested that you use a comparison tool that will present annualized premium and out-of-pocket cost estimates, while including your personalized prescription drug usage.
To compare premiums and prescription drug costs among different Medicare Advantage plans and start receiving the health coverage that best suits your needs, you can:
- Contact Medicare plans directly.
- Call 1-800-MEDICARE (1-800-633-4227), TTY users 1-877-486-2048; 24 hours a day, 7 days a week.
- Contact a licensed insurance agency such as eHealth.
- Call eHealth agents at 1- TTY users 711; .
- Or enter your zip code where requested on this page to see a quote.
Medicare Advantage Plans, sometimes called "Part C" or "MA Plans," are offered by private companies approved by Medicare and provide Medicare Part A and Part B coverage. Medicare prescription drug coverage is insurance run by an insurance company or other private company approved by Medicare. A Medicare Supplement plan is a health insurance plan provided by a private company that fills in the "gaps" in original Medicare coverage.
Medicare has neither reviewed nor endorsed this information.