Understanding Standard Medicare Plan Costs

Cost is just one of a number of factors to consider when evaluating your Medicare options. To determine your total costs when selecting a plan, it’s important to include your Medicare premiums, supplemental premiums, copays, deductible, coinsurance and the maximum out-of-pocket on your policy. Your evaluation of cost should accompany consideration of plan coverage and benefits. In this blog post, we’ll discuss the required and variable Medicare plan costs.

Understanding Medicare Costs

When it comes to understanding the costs associated with Medicare plans, there are a few important terms you’ll need to know. Here, we’ll dive into what these terms mean according to the Centers for Medicare and Medicaid (CMS) to help you evaluate the cost of your Medicare plan options.

Monthly Premiums –

“The periodic payment to Medicare, an insurance company, or a health care plan for health or prescription drug coverage.”

Deductible –

“The amount you must pay for health care or prescriptions before Original Medicare, your prescription drug plan, or your other insurance begins to pay.”

Copay –

“An amount you may be required to pay as your share of the cost for a medical service or supply, like a doctor’s visit, hospital outpatient visit, or prescription drug. A copayment is usually a set amount, rather than a percentage. For example, you might pay $10 or $20 for a doctor’s visit or prescription drug.”

Coinsurance –

“An amount you may be required to pay as your share of the cost for services after you pay any deductibles. Coinsurance is usually a percentage (for example, 20%).”

Out-of-Pocket Maximum –

“The most you have to pay for covered services in a plan year. After you spend this amount on deductibles, copayments, and coinsurance for in-network care and services, your health plan pays 100% of the costs of covered benefits.”

Professional Assistance Evaluating Medicare Costs and Plan Choices

Cost is one important determination in evaluating which Medicare coverage and benefits you select each year, and being able to forecast anticipated costs based on plan choice. Understanding the basic terminology surrounding Medicare costs is important in order for you to make an informed decision about which plan is best for your needs. For help evaluating any Medicare plan, including benefits and costs, contact Medicare Portal for free individualized assistance.


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