Cost can be an important consideration when shopping for any type of health insurance.
Here’s what you should know about Medicare Part C (Medicare Advantage) costs in 2019 and 2020, which can help you as you shop for Medicare Advantage plans in your area.
Medicare Part C plan costs for 2020 will be announced when new plans are offered for sale during the Medicare Annual Enrollment Period (AEP). But it’s never too early to start planning for your potential 2020 Medicare costs, such as premiums, deductibles and copayments.
Your Medicare Part C plan premium is the cost you must pay – typically monthly – to belong to the plan.
In 2019, the weighted average premium paid for a Medicare Part C plan was $29 per month. This varied from plans with premiums as low as $1 per month in South Carolina to as high as $121 per month in Minnesota.1
It’s important to note that many areas of the U.S. may feature $0 premium plans. In fact, close to half of all Medicare Advantage plan beneficiaries (59 percent) in 2019 pay no premium for their plan.1
In one example, 88 percent of Medicare Advantage plans in the state of Florida featured a $0 premium in 2019.1
In states like Florida, Alabama and South Carolina, as many as nine out of every 10 Part C members belonged to a $0 premium plan.1
Some variables that can affect the cost of a Medicare Part C premium include:
While most people do not pay a premium for Medicare Part A, beneficiaries typically pay the standard Part B premium, which is $135.50 per month in 2019.
People who report higher incomes may more for their Part B premiums, due to what is called the Medicare Income-Related Monthly Adjustment Amount (IRMAA).
A deductible is the amount you must pay out of your own pocket toward the costs of covered services and items before your plan coverage kicks in.
Some Medicare Advantage plans may include $0 deductibles.
In 2019, the weighted average Medicare Part C deductible (including plans with $0 deductibles) was $95 per year. South Carolina, Pennsylvania, Nevada and Kentucky all had a weighted average deductible of $15 or less in 2019.
On the other side of the spectrum, Montana’s average weighted premium was more than $400.
Medicare Part B requires an annual deductible of $185 for the year in 2019.
The 2019 Medicare Part A deductible is $1,364 per benefit period.
Cost-sharing measures are the share of medical bills that you must pay after your deductible has been met.
Cost-sharing can typically come in two forms:
Cost-sharing such as coinsurance and copays with Medicare Part C plans may vary by plan.
Part B of Medicare typically requires a 20 percent coinsurance payment for covered services and items (after you meet your Part B deductible).
Part A coinsurance can reach as high as $682 per day in 2019 for extended inpatient hospital stays.
A Medicare Advantage plan out-of-pocket spending limit represents an annual cap on your out-of-pocket spending for covered Part A and Part B health care costs.
Once you have reached this amount, your Part C plan will pay for 100 percent of the cost of all covered services and items for the remainder of the year.
In 2019, Medicare Part C plans carried an average out-of-pocket limit for in-network care of just under $4,800 per year. By law, all Part C plans must contain an out-of-pocket limit of no more than $6,700 in 2019.
The out-of-pocket limit can help protect you from Medicare out-of-pocket costs that can add up quickly as a result from a serious injury or illness that requires lengthy inpatient hospital stays.
Original Medicare does not feature an out-of-pocket limit, which can be one factor many beneficiaries may consider in joining a Medicare Advantage plan.
If you have questions about Medicare Part C costs or would like to compare Part C plans available in your area, call to speak with a licensed insurance agent today.
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