Before you make any decisions about Medicare, start by learning more about the components of cost sharing under Part C.
- Premium. If you join a Medicare Advantage plan, you continue to pay your Part B premium and - if you have one - your Part A premium. The plan may also charge its own premium, although some Medicare Advantage plans do not. Premiums for Medicare Advantage plans vary widely.
- Deductible. The fee you must pay for care before Medicare or a private insurance company begins to cover costs. Some Medicare Advantage plans charge deductibles and some don't. Look at the plan for specific details.
- Copayment (or co-pay). A fixed fee you pay at the time of service. Many plans charge co-payments, so look at the plan for details.
- For a Medicare Advantage plan, the co-pay is generally a pre-set, fixed dollar amount (For example, $20 for each office visit).
- If the Medicare Advantage plan includes prescription drug coverage, it likely requires you to cover a prescription drug co-pay in which you pay a certain amount for each prescription (e.g., a $7 co-pay for generic drugs after any required deductible is met).
- Out-of-Pocket Limits. Some Medicare Advantage plans protect you from high cost sharing by limiting the amount you will have to spend out of your own pocket. Part A and Part B do not have this feature.
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