Understanding Your Plan’s Costs
Updated: Jun 26
When shopping for or comparing different Medicare plans available to you, there are 4 main pieces to pay close attention to. After you have found a plan that meets your preferences for a network of providers and pharmacies, it’s important to compare the different cost aspects of a plan.
This is the amount you will pay monthly for your plan. This typically does not count towards your deductible or out-of-pocket maximum.
This is the amount you pay out of pocket for health care costs until your insurer picks up a greater share of the costs.
This is the amount you will pay out-of-pocket for medical visits, services, or prescription drugs.
This is the maximum out you will be required to pay out of pocket in a year before your insurer picks up 100% of the costs of your care.
Some Tradeoffs to Keep in Mind
Sometimes people pick a plan with a lower premium because they want to keep costs low. However, often a plan with a lower premium has a higher deductible. This means that if you have to use a lot of services, you will have to pay more out-of-pocket before your plan picks up a greater share of the costs.
Another thing to consider is the out-of-pocket maximum. Traditional Medicare plans do not have an out-of-pocket maximum. This means that even when you have met your deductible you will continue to have to pay a share of your medical costs, no matter how high they get. Most Medicare Advantage plans do have an out-of-pocket maximum, but be sure to check what they are.