Typical cost of a Medicare Advantage Plan

How much does a typical Medicare Advantage Plan cost?

There is no one size fits all price for a Medicare Advantage Plan. Your out-of-pocket costs for your Medicare Advantage plan can depend on a variety of different factors. 

Some of these factors include: 

  • Whether or not your plan charges a monthly premium (some plans will not have a premium) 
  • How much you pay in copayments or coinsurance 
  • The type of services you need and how often you receive them 
  • If the plan has a yearly deductible or any additional deductibles 
  • The type of health care services you need and how often you get them

Plans change the amounts they charge for premiums, deductibles, and services. The plan decides how much you pay for the covered services. What you pay for the plan may only change once a year on January 1. 

How do Medicare Advantage Plans Work?

To enroll in a Medicare Advantage Plan, you must be enrolled in Medicare Part A and Part B. When you receive healthcare services, you will present your Medicare Advantage Plan card as payment. 

Depending on the Advantage Plan you enroll in, like an HMO Plan, for example, you may be required to see a primary care physician that is in the plan’s network. Your Advantage Plan will cover those services. However, if you receive healthcare services from a provider not within your plan’s network, you may have to pay those costs out-of-pocket without receiving coverage. 

Keep in mind that even if you’re enrolled in a Medicare Advantage Plan that doesn’t require you to see a primary care physician within its network and allows out-of-network coverage, such as a PPO Plan, you may still have more expensive out-of-pocket costs than you would if the physician was in-network. These costs can include a more expensive coinsurance.

Out-of-Pocket Maximum

All Medicare Advantage Plans have an out-of-pocket maximum that limits how much you spend out-of-pocket for your medical costs each year. Once you reach that limit, your Medicare Advantage Plan will pay 100% of any other eligible expenses you receive for the remainder of that year. However, this only applies to Part A and B expenses and does not count for any prescription drugs (Part D), dental, vision, or hearing expenses.

To figure out how much your Medicare Advantage Plan will cost, reach out to Temmen Insurance at 417-633-7200. We will help you stay informed on all things Medicare.

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