Copayments
A copayment, or copay, is the amount you pay to a healthcare provider or pharmacy at the time of service. Copayments vary depending on your plan and the services you receive. For example, you may have a $40 copayment for a doctor's office visit.
Prescription drug costs
A Medicare Advantage plan that includes drug coverage is called a Medicare Advantage prescription drug plan (MAPD). Most MAPD plans offer an affordable or even $0 monthly plan premium, but you might have to pay the Medicare Part B premium. Some MAPD plans also charge a drug deductible.
Out-of-pocket maximum
Your out-of-pocket maximum is the most you have to pay for covered healthcare services in a plan year. For example, if your out-of-pocket maximum is $5,000, once you’ve paid $5,000, your plan pays 100% of all covered services for the rest of the plan year.
What can impact my Medicare Advantage costs?
MA plans set their costs for premiums, deductibles and services on Jan. 1 every year.2 These costs won’t change the rest of the year.
Outside of those fixed costs, other things that can impact what you pay include:
- The type of MA plans you choose
- The type of healthcare services you need
- How often you get healthcare services
- Whether you go to a doctor or supplier in the plan’s network
- The maximum out-of-pocket limit set by your plan
Compare Medicare Advantage plans
There are 4 common Medicare Advantage plans: Health maintenance organization (HMO) plans , Preferred provider organization (PPO) plans , Private fee-for-service (PFFS) plans and Special Needs Plans (SNPs) .
To check what plan could be best for you, compare Medicare Advantage plans today.