How Can I Compare Prices of Different Medicare Plans?
If you’re looking for additional Medicare coverage beyond Original Medicare (Part A and Part B), you may want a Medicare plan from a private insurance company approved by Medicare. Here’s how you can compare Medicare prices of Medicare Advantage, Medicare Supplement, and Medicare Part D Prescription Drug Plans. Keep in mind that most Medicare plans may cost you in more than one way. When you compare Medicare prices, be sure to look at all the charges, not just one, to find the lowest-cost plan.
Medicare prices for Part D Prescription Drug plans
You can get a stand-alone Medicare Part D Prescription Drug plan to go alongside Original Medicare. The private insurance companies that offer these plans have flexibility in how they price their plans.
- Premiums: This is the amount you have to pay monthly to have the plan, regardless if you fill prescriptions or not. Medicare Part D plans are not available with zero-dollar premiums. Deductible: this is the amount you pay before the plan begins to pay. Medicare Part D deductibles are regulated by Medicare and have a yearly limit
- Coinsurance or copayment: this is the amount you pay when you fill a prescription. A coinsurance is a percentage, for example 20%; a copayment is a dollar amount, for example $15. Keep in mind that many Part D plans use tiers, placing different prescription drugs on tiers from 1 to 6. Prescription drugs on tier 1 (generics) generally have lower copayments/coinsurance than tier 5 prescription drugs, which are specialty medications.
Costs for Medicare Advantage plans
The costs for Medicare Advantage plans include premiums, deductibles, and copayments/coinsurance.
- Premium: this the amount you pay monthly to have the plan. Some Medicare Advantage plans have premiums as low as $0, but you must continue to pay your Medicare Part B premium when you have a Medicare Advantage plan.
- Annual Deductible: This is the amount you must pay out of pocket before your plan begins to cover any costs. Some Medicare Advantage plans don’t have deductibles
- Coinsurance or copayment: You may pay different copayments for different services. For example, a visit to your primary care doctor could be $10 and a visit to a specialist could be $30. You also may pay copayments for other services, such as emergency room visits, ambulance services, and X-ray services.
- Out of pocket maximum: Keep in mind that unlike Original Medicare, Medicare Advantage plans have out-of-pocket maximums. This amount can differ from plan to plan.
According to eHealth research, the average out-of-pocket limit for Medicare Advantage plans decreased from $5,815 to $5,164 in 2019.
- Premiums and out-of-pocket costs are top considerations when choosing Medicare coverage, according to eHealth research in 2019.
Medicare Prices for Medicare Supplement Insurance plans (Medigap)
Medicare Supplement insurance plans are offered by private insurance companies and can cover some Medicare costs, including copayments, coinsurance and deductibles
- Premium: You generally have to pay a monthly premium to have a Medicare Supplement plan. The premium for a Medicare Supplement plan varies from plan to plan. Keep in mind that there are up to 10 Medicare Supplement plans (A, B,C, D, F, G, K, L, M, N) which offer very different levels of coverage. When you’re comparing Medicare Supplement plans, you may notice that plans with more extensive coverage may charge higher premiums than plans with less extensive coverage.
- Deductible: There are separate deductibles for Original Medicare Part A and Medicare Part B that change from year to year
- Out-of-pocket maximum: Only Medicare Supplement plans K and L have out-of-pocket maximums
This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year.