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Medicare Cost Plans

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Medicare cost plans are somewhat similar to Medicare Advantage plans. Here’s a quick summary of Medicare cost plans.

What is a Medicare cost plan?

Medicare cost plans are a type of Medicare health plan. Private insurance companies contract with Medicare to deliver your Original Medicare (Part A and Part B) benefits.

A Medicare cost plan may have a provider network. If you go outside the plan network, even without a referral, generally Medicare Part B covers your doctor visits and other Medicare-approved expenses. Coinsurance and deductible amounts may apply.

Medicare cost plans may not be available in all areas.

Who’s eligible for a Medicare cost plan?

You’re generally eligible for a Medicare cost plan if all of the following are true:

  • You’re enrolled in Medicare Part B, and eligible for Part A.
  • You live in the plan’s service area. In some cases, you can live outside the plan’s service area.
  • The plan is accepting new patients.
  • You agree to follow the plan’s membership rules.
  • You don’t have end stage renal disease (ESRD, a type of permanent kidney failure). There are some exceptions.

If you’d like to enroll in a Medicare cost plan and have questions about your eligibility- or anything else – call the plan and ask.

Medicare cost plans are being phased out in some areas starting in 2019

According to the Minnesota Board on Aging, insurance companies will be required to discontinue Medicare cost plans in counties where at least two competing Medicare Advantage plans were available the year before, if they met certain enrollment thresholds.

When can you sign up for a Medicare cost plan?

You can generally sign up for a Medicare cost plan anytime as long as you meet eligibility requirements and the plan is accepting new members. That’s one way Medicare cost plans are different from Medicare Advantage plans, which have specific enrollment periods.

Still have questions about Medicare cost plans or other Medicare health plans? You can call eHealth to speak with a licensed insurance agent. If you’d like to explore the various Medicare coverage options in your area, use the Browse Plans button on this page.

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