Medicare Cost Plan And Medicare Advantage Plan: What Exactly Is The Difference?
Depending on where you live, the Medicare cost plans may be able to offer older adults the best of both worlds. Those who wish to keep the flexibility associated with the original Medicare while at the same time having access to health care providers out of their network.
The main difference between the Medicare cost plan and other plans by Medicare is that enrollees are not restricted to the network of providers who are a part of the plan. They can therefore go outside of the network to gain access to Medicare covered services.
Medicare is the health insurance program of the state for those people who are aged 65 and older as well as for those who may have some kind of disability. Medicare Part A covers inpatient hospital stays while the Part B covers services of doctors. Medicare part C is also known as the Medicare advantage plan which is offered by private companies while Medicare part D offers coverage for prescription drugs.
In some parts of the country, adults are given the option to enroll in Medicare plans offered by private companies. However unlike the Medicare advantage plan, those opting for the Medicare cost plan are allowed to maintain their original Part A and B coverage.
Medicare cost plans are seen to be hybrids between health maintenance organizations which have a restriction on the network of providers for their enrollees and those who are preferred provider organizations which have a wide network of providers.
Some Medicare cost plans contain coverage for prescription drugs or individuals are also given the option of purchasing stand along Medicare plans for prescription drugs. Those who wish to opt for out of network care pay the deductible and the coinsurance for Part A and B. in order to gain access to the services, enrollees must show their original Medicare card as well as their cost plan card. Those with Medicare cost plans can also return to the original Medicare at any time, even apart from the Medicare open enrollment period.
Historically, Medicare cost plans provided people with a managed care option in areas of the country where only a few Medicare advantage plans were found. Medicare cost plans pay is based on a reasonable cost of delivering the services while the Medicare advantage plan accept the financial risk if the cost exceeds the fixed payment per enrollee. The original Medicare plan comes in with respect to the Medicare cost plan when the enrollee opts for out of network care instead of when the cost is exceeded.
Due to this purpose, when consumers are trying to decide between the Medicare advantage and Medicare cost plans offered by private companies, they should consider whether or not they would want access to hospitals and doctors who are located out of network. Those with Medicare cost plans can go to providers who are out of network since their original Medicare plan kicks in then and the enrollee is expected to pay the deductible for Part A and B. this is one of the main reasons why the Medicare cost plan is convenient for those who travel a great deal during their retirement age. Those consumers having a Medicare advantage plan can see in-network providers and pay out of pocket if they plan to travel to areas which are not covered by their plan.
This is the primary difference between the Medicare cost plan and the Medicare advantage plan. Thus knowing the difference between what the two provide can help you in making a better decision and one which is suited to your needs and requirements.