Understanding Medicare Cost Plans

Medicare is great in that helps pay for services and treatments that could easily drain an enrollee’s bank account. There is little that will lower medical expenses, but you do have the option of getting additional coverage to protect yourself from having to pay those expensive bills yourself.

When comparing the many different types of Medicare health care plans, there are some that provide health care options that are not actual Medicare Advantage plans, but yet are still a part of Medicare. Some of these will offer Medicare Part A and Part B coverage, while many others will offer coverage only for Medicare Part B. Still others will include coverage for Medicare Part D, prescription drugs. 

With these plans, many of the same rules will apply that are present in Medicare Advantage plans. Yet, there may also be certain other rules and exceptions that are present within these plans. One of these specialized plans includes the Medicare Cost Plans.

Medicare Cost Plans are a unique type of Medicare product that helps enrollees with covering the costs that Original Medicare (Medicare Part A and Medicare Part B) does not cover. These plans are considered to be a type of “hybrid” in that they are essentially a cross between a Medicare Advantage plan and a Medicare Supplement insurance plan - and in many ways, they may seem like the “best of both worlds” when it comes to benefits. When considering a Medicare Cost Plan, however, it is important to understand exactly what benefits you are, and are not, getting.

What are Medicare Cost Plans and How Do They Work?

While they may seem somewhat similar, Medicare Cost Plans are technically not a type of Medicare Advantage plan. They work in a somewhat similar fashion to an HMO (Health Maintenance Organization). However, if an enrollee receives his or her services from a provider that is outside of the plan’s network without first obtaining a referral, then their Medicare covered services will be paid for under the Original Medicare Plan (Medicare Part A and Part B).

With one of these Plans, an individual can join even if they only have Medicare Part B. This is unlike Medicare Advantage plans that require enrollees to have both Medicare Part A and Medicare Part B in order to enroll.

A Medicare Cost Plan will allow individuals can enroll whenever the plan is accepting new members, and members can likewise leave at any time and go back on their original medicare plan.

Members in a Medicare Cost Plan are allowed to obtain their Medicare prescription drug coverage from the plan, provided that it is offered. If this coverage is not offered directly through the Medicare Cost Plan, members are allowed to join a Part D Medicare prescription drug plan. (Note that enrollees are only allowed to join or cancel Medicare Part D prescription drug plans at certain times).

Other Options

In addition to an individual Medicare Cost Plan, there is also a type of plan that offers coverage for Medicare Part B services that is sponsored by employers, unions, or companies that do not provide Medicare Part A services. In this case, the Medicare Part A services would be offered via Original Medicare. These particular Medicare Cost Plans do not include Medicare Part D prescription drug benefits.

Before you decide which type of health care plan you want to enroll in, you need to decide which fits your needs the best. You’ll need to look at your budget and think about which one is going to fit your health care preferences and will give you the best coverage based on your circumstances.

As we mentioned earlier, you could also choose to get a Medigap Supplemental plan that will give additional coverage not offered my Medicare. Though close in coverage to Cost plans, MedSupps do have a few differences to them. They’re offered through private insurance companies and save you money by covering things A and B don’t offer coverage on.

Medigap Supplement Plan F is the plan that offers most coverage but is also normally the most expensive. There are nine other plans available; a few of the other popular plans are A, N, and G.

There are ten different plans that you have to weight to decide which one works best for you.

One of thee main differences between a Cost Plan and a Medigap plan is that Cost Plans can give prescription coverage, but no supplemental insurance policy helps with drug costs. For anyone that is looking to offset the costs of prescription drugs, the Medigap policies aren’t going to help, but that doesn’t mean you should automatically discount them for their worth.

If you have any questions about the different Medigap policies or a Medicare Cost plan, call us. We know that trying to decide which type of additional coverage plan works best for you can be a confusing and frustrating process. Our agents will make sure that you have the additional coverage that you deserve. There are millions of Medicare enrollees that want additional coverage that they aren’t getting from Parts A or B, and our goal is to find the perfect plan for your needs.