How much does Medicare Advantage cost?
- Medicare Advantage plansMedicare Advantage (MA), also known as Medicare Part C, are health plans from private insurance companies that are available to people eligible for Original Medicare (Medicare Part A and Medicare Part B).... (Part C) have a monthly premiumA premium is an amount that an insurance policyholder must pay for coverage. Premiums are typically paid on a monthly basis. In the federal Medicare program, there are four different types of premiums. ... that’s in addition to your Medicare Part BMedicare Part B is medical coverage for people with Original Medicare. It covers doctor visits, specialists, lab tests and diagnostics, and durable medical equipment. Part A is for hospital inpatient care.... premium.
- Many plans have a $0 cost. This simply means that your Medicare Part B premium covers the full amount.
- Some plans charge an additional premium in the range of $10 to nearly $400 per month.
- Each plan’s premium is based on government subsidy, additional services, and delivery cost based on the type of plan, size of network, local costs, etc.
How Medicare Advantage Works
Medicare Advantage plans are not a one-size-fits-all solution, like Original Medicare. Private health insurers and healthcare systems that Part C plans are free to add health benefits that Original MedicareOriginal Medicare is private fee-for-service health insurance for people on Medicare. It has two parts. Part A is hospital coverage. Part B is medical coverage.... (Parts A and B) do not cover. The most common addition benefit is prescription drug coverage. As a result, what you pay for Medicare Advantage (MA) depends on the type of insurance plan you choose.
The most common choices are preferred provider organization (PPO) plans, health maintenance organization (HMO) plans, and private-fee-for-service (PFFS) plans. Other types include medical savings account (MSA) and Medicare Cost plans, however, these are less common.
Common Advantage Plan Additional Benefits that add Cost
Part C plans must provide all of the health coverage built into Part AMedicare Part A is hospital inpatient coverage for people with Original Medicare, whereas Part B is medical coverage for doctor visits, tests, etc.... and Part B. However, these services are provided by private insurance companies approved by Medicare. In addition to what’s covered by Original Medicare, many private plans include:
- Prescription benefits (within the Part DMedicare Part D is Medicare's prescription drug plan program. Plans are offered by private insurance companies and cover outpatient prescriptions.... requirements)
- Vision
- Dental
- Hearing
- Health/wellness programs, like Silver Sneakers.
Premium Cost Factors
Premium costs vary widely based on several factors:
- Annual maximum out-of-pocket (MOOP) amount;
- Beneficiary co-payments and/or co-insurances;
- Value of additional services; and
- Level of choice (e.g., selection of doctors and service providers) offered to beneficiary.
Beneficiaries should know that Advantage plans are subsidized by the federal government. So, in addition to the monthly premium a members pays for their plan, the federal government pays a fixed amount each month on behalf of the beneficiary.
NOTE: Plans with a 5-star rating are paid a bonus amount for each beneficiary enrolled in a 5-star plan.
Related FAQs
- How Much Does Medicare Hospital Insurance Cost (Medicare Part A)?
- How Much Does Medicare Medical Insurance (Part B) Cost?