CostShare Report FAQs

 

Exactly what do the COSTSHARE REPORT findings represent?

The findings do represent how cost-sharing (out-of-pocket expenses) can vary among Medicare managed care plans that offer similar benefits and services when adjusted for enrollee health status.

The findings do compare plans based on the applicable annual out-of-pocket expenses (copayments, premiums, deductibles) that enrollees incur for the approved benefits and services provided under each plan.

The findings do represent each plan's cost-sharing requirements as posted on the Medicare Plan Finder at www.Medicare.gov.

 

What do the COSTSHARE REPORT findings not represent?

The findings do not represent a guarantee of the actual annual out-of-pocket expenses that Medicare beneficiaries would incur upon enrolling in a plan.

The findings do not compare provider networks, financial stability, quality of care, enrollee satisfaction, or other managed care plan performance measurements.

The findings do not represent the cost-sharing requirements for Medicare beneficiaries enrolled in employer-sponsored group retirement plans.

 

What limitations should Medicare beneficiaries take into consideration when using the COSTSHARE REPORT findings?

COSTSHARE REPORT findings have not been verified for accuracy by each plan.  Nevertheless, certain limitations or benefit restrictions may apply that can affect the annual out-of-pocket expenses shown in the COSTSHARE REPORT examples.

Plan benefits, copayments, deductibles, and monthly premiums are subject to change by the Centers for Medicare & Medicaid Services (CMS).

Medicare Part B monthly premiums ($134 or $109 in 2019 for most beneficiaries) are included in the cost-sharing comparisons and must continue to be paid as a condition for enrollment in all Medicare Advantage plans.

Cost-sharing dollar differences between individual plans may range from as little as $1 to over $500.  Each COSTSHARE REPORT user should decide whether the annual cost-sharing dollar differences are sufficient for selecting one plan over another.

Although COSTSHARE REPORT comparisons are important, they should not be the sole basis for either selecting or not selecting a Medicare Advantage plan.

 

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*Annual estimated costs (out-of-pocket expenses) include applicable 2019 plan copayments, deductibles, and premiums as posted on Medicare Plan Finder (www.Medicare.gov). Medicare Part B monthly premiums ($135.50 in 2019 for most beneficiaries) are not included.  Estimated costs may be greater for beneficiaries who are late enrolling for Medicare Part D (prescription drug) coverage or lower for beneficiaries with limited income and resources who may be eligible for low-income subsidies.  Estimates do not include cost-sharing for additional popular benefits provided by some plans, e.g., eyewear, hearing aids, transportation.  

The information contained herein is neither guaranteed nor intended to represent actual enrollee experiences for any Medicare plan.  HealthMetrix Research Inc. does not endorse or recommend specific Medicare plans. 

Medicare has neither reviewed nor endorsed this information.  The Senior Choice Gold Award is not given by Medicare.

This is not a complete listing of plans available in your service area.  For a complete listing, please contact 1-800-MEDICARE or consult www.Medicare.gov

(TTY users should call 1-877-486-2048, 24 hours a day/7 days a week or consult www.Medicare.gov.) 

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