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Medicare Advantage plans vs Medicare Cost plans

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If you’re receiving Social Security benefits you may be automatically enrolled in Medicare Part A (hospital coverage) and Part B (medical coverage). Medicare Part A and Part B are also called Original Medicare. However, Original Medicare is not the only way to receive your Medicare benefits.

Medicare Advantage plans and Medicare Cost plans are alternative ways to receive your Medicare benefits. Original Medicare is administered by the government, while Medicare Advantage plans and Medicare Cost plans are administered by private insurance companies contracted with Medicare.

What is a Medicare Advantage plan?

Medicare Advantage is also called Medicare “Part C.” With Medicare Advantage, you’ll get your Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) through a private company and not through Original Medicare. Medicare Advantage plans also often provide coverage for Medicare Part D, prescription drugs, which Original Medicare usually doesn’t cover. In addition, Medicare Advantage plans often offer extra benefits not generally covered by Original Medicare, such as vision, hearing, and sometimes dental. You must continue to pay your Medicare Part B premium.

Medicare beneficiaries with end-stage renal disease (ESRD) usually cannot enroll in Medicare Advantage.

What is a Medicare Cost plan?

Medicare Cost Plans are Medicare health plans that are available in certain parts of the country. The availability of Medicare Cost Plans depends on the insurance companies offering them, not on Medicare. Medicare Cost Plans may offer coverage for prescription drugs and other benefits, such as hearing and vision coverage not usually provided by Original Medicare.

Medicare beneficiaries with end-stage renal disease (ESRD) usually cannot enroll in a Medicare Cost Plan.

Learn more about Medicare Cost plans here.

What are the main differences between a Medicare Advantage plan and a Medicare cost plan?

The table below helps illustrate the main differences between a Medicare Advantage plan and a Medicare cost plan.

Medicare Advantage Plan Medicare Cost Plan
Enrollment To Enroll in a Medicare Advantage plan you must have both Medicare Part A and Part B. You can enroll in a Medicare Cost plan even if you only have Medicare Part B.
When to enroll You can generally only enroll in, switch, or disenroll from Medicare Advantage during certain times of the year. Learn more about Medicare Advantage enrollment periods. You can enroll in a Medicare Cost Plan anytime the plan is accepting new members and you can leave at any time and return to Original Medicare.
Coverage Medicare Advantage covers both hospital care (Part A) and medical care (Part B). Some types of Medicare Cost Plans only cover medical care while hospital care is covered through Original Medicare Part A. If you have this type of Medicare Cost Plan and don’t have Medicare Part A, you may not be covered for hospital care.

Do you have more questions about Medicare coverage?

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Benefits, premiums and/or copayments/co-insurance] may change on January 1 of each year.

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