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Medicare Advantage Costs: What You Need to Know

On the whole, Medicare Advantage costs are down in 2019. Specifically, Medicare Advantage premiums have dropped an average 6 percent, from $29.81 to $28. But premiums aren’t the only Medicare Advantage costs you should take into account when considering plans. You’ll also need to factor in deductibles, copays, and out-of-pocket maximums before committing to a plan.

What is Medicare Advantage?

Medicare Advantage (Medicare Part C) is Medicare coverage offered through private insurance companies that are approved and regulated by Medicare. Under Medicare Advantage, you still have all the coverage provided by Original Medicare (Part A and Part B), but some plans offer extra benefits like dental, hearing, vision, and prescription drug coverage.

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Medicare Advantage costs

Medicare Advantage costs will vary based on your plan, and plan availability will vary based on where you live.

  1. Premiums. A premium is the monthly fee you pay for your health plan. In addition to your Medicare Part B premium, you will also need to pay a premium for your Medicare Advantage plan. The average premium for a Medicare Advantage plan in 2019 is $28. However, some plans have premiums of $0 while others have $200 monthly premiums. In addition, some Medicare Advantage plans may also cover a portion of your Part B premium.
  2. Deductibles. A deductible is the total amount of money you need to spend before your plan will begin to pay for your benefits. Only some Medicare Advantage plans have deductibles. While you have a Medicare Advantage plan, you will not be responsible for the Part B deductible.
  3. Copays and coinsurance. A copay is a flat fee paid at the time of service, and coinsurance is a percentage of the total costs you will need to pay. If you see an out-of-network provider, your copay may be significantly higher than it would be if you stay it network. Medicare Advantage plans have the right to change their copay and coinsurance amounts from year to year, but once the amount is locked in on January 1, the amount cannot be changed again for the rest of the year.
  4. Out-of-pocket maximums. An out-of-pocket maximum is the total amount of money you need to spend in a year before your plan will start covering all of your costs. Once you meet your out-of-pocket maximum on premiums, deductibles, and copays, your plan will cover 100 percent of covered services. For 2019, no Medicare Advantage plan may have an out-of-pocket max exceeding $6,700, but some plans may have lower maximums.

If you have questions about Medicare Advantage costs under your specific plan, call your insurer directly.

To find a Medicare Advantage plan in your area, use Medicare’s plan finder.

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