Medicare Cost Plans: Coverage, Benefits and Costs

A Medicare Cost plan can be similar to a Medicare Advantage plan in some ways, but with a few key differences.

In this article we outline some of the benefits of each type of health insurance plan and discuss how you can determine which type of plan may fit your health care needs.

Doctor talking with her patient

What is a Medicare Cost Plan?

Medicare Cost Plans are plans sold by private insurance companies and can offer additional benefits not found in Original Medicare (Medicare Part A and Part B).

Medicare Cost Plan beneficiaries maintain their Part B coverage (medical insurance) and combine that with the additional benefits offered by their Medicare Cost Plan.

Medicare Cost Plans vs. Medicare Advantage Plans

Medicare Cost Plans are sometimes described as a type of Medicare Advantage plan. There are four key differences, however, that distinguish a Medicare Cost Plan from a Medicare Advantage plan:

  • The benefits offered by a Medicare Advantage plan are used instead of Original Medicare. Meanwhile, the benefits offered by a Medicare Cost Plan are used in addition to your Original Medicare coverage.

    In other words, with a Medicare Cost Plan, you will continue to be covered by your Original Medicare benefits as needed. Any additional benefits provided by the Medicare Cost Plan will then be used on top of that Original Medicare coverage.

    A Medicare Advantage plan replaces your Original Medicare benefits, except for hospice care, which is still covered by Medicare Part A.

  • With a Medicare Cost Plan, you can visit health care providers outside of the plan’s network and still receive Medicare-covered services via Original Medicare, as long as your provider accepts Medicare.

    With a Medicare Advantage plan, you may be limited to using providers within the plan’s network for health care services. Some Medicare Advantage plans allow you to see providers outside of your plan network, though you may pay more for eligible services.

  • To enroll in a Medicare Advantage plan, you generally have to wait for certain enrollment periods. This is typically not the case with Medicare Cost Plans, as you can apply for them at any time of year in most cases.

  • You only need to be enrolled in Part B of Medicare in order to enroll in a Medicare Cost Plan. Medicare Advantage plans require both Part A and Part B enrollment.

Who might consider enrolling in a Medicare Cost plan?

Most people qualify for premium-free Medicare Part A after working and paying Medicare taxes for at least 10 years. But those who do not qualify for premium-free Part A face monthly premiums that can be as high as $437 per month in 2019.

As long as you are at least 65 years old and are either a U.S. citizen or a legal resident that has lived in the U.S. for at least five years, you can enroll in Medicare Part B without having to get Part A.

Anyone who wishes to obtain some additional benefits without having to pay a large monthly premium for Medicare Part A might consider a Medicare Cost Plan.

Find a Medicare Advantage plan that fits your needs

Would you rather have a Medicare Advantage plan instead of a Medicare Cost plan? You can learn more and compare Medicare Advantage plans that are available where you live by calling a licensed insurance agent at TTY Users: 711.     

Copyright © 2018 TZ Insurance Solutions LLC. All rights reserved.

MedicareAdvantage.com is a website owned and operated by TZ Insurance Solutions LLC. TZ Insurance Solutions LLC and TruBridge, Inc. represent Medicare Advantage Organizations and Prescription Drug Plans having Medicare contracts; enrollment in any plan depends upon contract renewal.

Plan availability varies by region and state. For a complete list of available plans, please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.

Medicare has neither reviewed nor endorsed this information.