If You Have a Medicare Cost Plan, It Could Be Your Year to Shop

Posted by Medicare Made Clear

Fall is Medicare plan shopping season. The Annual Enrollment Period starts on October 15 and runs through December 7.

It’s a good idea to review your Medicare coverage every year – and change it if needed. This year, it’s not only wise, it may be necessary.

Medicare Cost Plans Closing

By law, Medicare Cost plans are closing in counties served by two or more competing Medicare Advantage plans that meet set enrollment criteria. This includes counties in several states and the District of Columbia. Cost plans currently operating in affected counties will not be offered for 2019.

You need to be extra alert for information or notifications you get from your plan if you are a Cost plan member. Your plan may be closing completely, or it may be converting to a Medicare Advantage plan. Your enrollment may be “deemed” if your Cost plan converts. This means that your enrollment automatically transfers to the converted Medicare Advantage plan for next year unless you make a different choice during Medicare’s Annual Enrollment Period, Oct. 15 – Dec. 7.

What is a Medicare Cost Plan?

Medicare Cost plans share features with both Medicare Advantage and Medicare supplement plans.

• Cost plans work like a Medicare Advantage plan (Part C) when you get care from network providers. You usually pay a copay for services and the plan pays the rest.
• Cost plans work like a Medicare supplement plan when you get care from providers outside the plan network. Original Medicare (Parts A & B) pays a share of the cost, you may pay a share, and the plan pays a share.
• Cost plans may cover prescription drugs and offer additional benefits such as dental and vision care or fitness programs like many Medicare Advantage plans do. Original Medicare does not provide these benefits.
• Cost plans allow you to enroll in or switch plans at any time like Medicare supplement plans do. Medicare Advantage and standalone prescription drug plans (Part D) have set enrollment periods.

How to Tell if You Have a Cost Plan

The simplest way to tell if your plan is a Cost plan is to look at the plan name on your insurance card. If “Cost” is in the name or noted near the name, then that’s what it is.

Other telltale signs that you have a Cost plan include the following.

• You are able to change or drop your plan at any time, not just during set enrollment periods.
• Your plan has a provider network but you are not required to use it.
• Care that you get outside of the plan network is covered under Medicare Part A or Part B.

Call your plan to get more information if you’re not sure whether it’s a Cost plan.

About 400,000 Minnesotans Have Medicare Cost Plans

Minnesota has the largest concentration of Cost plan enrollees nationwide, and plans are set to close in 66 of the state’s 87 counties. If you live in one of the counties highlighted in the map below – and you have a Cost plan – make sure you understand your options.

Minnesota Cost plans include the following:

• Blue Cross Blue Shield of Minnesota Platinum Blue plan
• HealthPartners Freedom plan
• Medica Prime Solution plan

Your plan should notify you about changes, including if it’s converting to a Medicare Advantage plan and what that may mean for you. Don’t hesitate to call the number on the back of your insurance card to talk to a plan representative and get the information you need.

What to Do If You Have a Cost Plan

First and foremost, you need to know if your Cost plan is closing or converting to a Medicare Advantage plan. If it’s closing, you need to shop for a new plan. If it’s not closing or it’s converting, you’ll want to review the plan details to see how it will meet your needs going forward.

You may find you have good reasons to shop for a new plan. Take these steps to help find a plan that’s a good fit for you.

1. Learn about all your Medicare coverage options.
2. Identify your health care and budget needs.
3. Find plans offered where you live.
4. Choose a new plan based on your needs.

It May Be a Good Year to Shop for a Medicare Plan

You may have to shop because your Cost plan is closing, or you may choose to shop to see what’s out there. Either way you may have more and better Medicare plan choices than ever before.

Medicare Advantage plans in your area may be offering new benefits and features such as more coverage while traveling, coverage for hearing aids, no-charge fitness trackers and more.

Comparison shopping could pay off.

Related Content

5 Medicare Mistakes That Could Cost You
Medicare Supplement vs. Medicare Advantage
How to Get Dental and Vision Care Coverage When You Have Medicare

For more information, explore MedicareMadeClear.com or contact the Medicare helpline 24 hours a day, seven days a week at 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048.

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