What are the other Medicare Health Plan options? How do these differ from a Medicare Advantage Plan?
Medicare offers three additional plans that are not part of the Medicare Advantage program, but are still within the Medicare system. Each plan addresses certain needs. Please see below for details.
In each case, you sign up with an approved private insurer. Then Medicare pays a given amount each month to that company for your health care. Depending on the plan, it may also cover prescription drugs. These plans are the Medicare Cost Plans, Demonstrations plans, and PACE Plans (or Programs of All-inclusive Care for the Elderly).
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Medicare Cost Plans
Medicare Cost Plans work much like the Medicare HMOs. In the Medicare Cost Plans, for instance, you sign up for a network of doctors and hospitals that have been approved by Medicare. Unlike the HMO plans, however, a Medicare Cost Plan does offer you the advantage of covering any care you receive from a doctor outside of the approved network.
Prescription drugs may be covered, but these plans do not offer some of the additional benefits or savings of the HMO plans, such as covering the Medicare Part A and B deductibles. You can join a Medicare Cost Plan whenever it is accepting new members and leave, to return to the Original Medicare Plan, at any time.
Medicare Cost Plans are only available in certain areas of the country. To find out if this type of plan is available in your area, check with your local Medicare adminstrative office.
Demonstrations
Sometimes Medicare tests new plans in an attempt to make improvements to its medical coverage, costs or quality of care. Usually Demonstration plans are only offered to certain groups of people and/or in certain areas of the country. Medicare uses the results of these tests to develop its future plans for everyone.
To find out if a Demonstration plan is available in your area, visit the Medicare website for details or contact your local office.
PACE (Programs of All-inclusive Care for the Elderly)
The Original Medicare , while paying for much of your hospital care, does not offer much coverage for long-term care. The costs of prolonged nursing care, for example, fall to you. One way to address this is to take out additional insurance specifically for long-term care.
Not everyone can afford to pay an addition premium, however. PACE plans were designed to offer help under Medicaid to seniors who have limited income or resources. These plans may provide prescription drug coverage as well.
So far, PACE plans are only available in certain states. Qualifications vary from state to state. To find out if there are PACE plans in your area and whether are eligible, consult your State Medical Assistance office. You can also visit the web for PACE locations and telephone numbers.
For more information, please also see Help for People with Limited Income and Resources.
For help evaluating the best plan for your needs, please review our section on your costs with the Medicare Advantage program >>
Or, Request a free quote from carriers in your area offering Medicare solutions >>
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