Other Medicare Health Plans

Aside from Medicare Parts A and B and Medicare Advantage Plan, Medicare offers other options. These plans have some of the same rules however, each type of plan has special rules and exceptions.

Medicare Cost Plans

These are the type of Medicare health plans available in certain, limited areas of the country.

Here's what you should know about it;

You can join even if you only have Part B
If you have Part A and Part B and go to a non-network provider, the services covered are under Original Medicare.
You can join anytime
You can leave anytime and return to Original Medicare
You can either get your Medicare prescription drug coverage from the Cost Plan or you can join a Medicare Prescription Drug Plan. (You can add or drop Medicare prescription drug coverage only at certain times)

Programs of All-inclusive Care for the Elderly (PACE)

This is a Medicare and Medicaid program offered in many states that allows people who otherwise need a nursing home-level of care to remain in the community.

To qualify, you must be;

55 or older
live in the service area of PACE organization
certified by your state as needing a nursing-home level of care
able to live safely in the community with the help of PACE services

PACE covers all Medicare and Medicaid-covered care and services and other services that the PACE team of health care professionals decides are necessary to improve and keep up your health.

If you have Medicaid, you won't have to pay a monthly premium for the long-term care part of the PACE benefit.

If you have Medicare, you'll be charged a monthly premium to cover the long-term care part of the PACE benefit and a premium for Medicare Part D drugs. However, in PACE, there's never a deductible or copayment for any drug, service or care approved by the PACE team.

Medicare Innovation Projects

Medicare develops innovative models, demonstrations and pilot projects to test and measure the effect of potential changes in Medicare. These projects help find new ways to improve health care quality and cut costs.

Examples of current projects include innovations in primary care, care related to specific procedures, Cancer care and care for people with End-Stage Renal Disease.

To learn more about the current Medicare projects, call 1-800-MEDICARE, TTY users can call 1-877-486-2048.

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Medicare Part D Costs for 2020

Before 2006, Medicare did not cover prescription medications. There was a limited number of medications that were offered under Medicare Part Band, and otherwise, you had to pay for your medications out of pocket. In 2003, everything had changed when President George W. Bush passed the Medicare Prescription Drug, Improvement, and Modernization Act (MMA). This is what we now know of as Medicare Part D , an optional part of Medicare that provides prescription drug coverage. Part D plans are run by private insurance companies and not by the government. However, the federal government sets guidelines on what basic medications are covered and how much you can be charged. A deductible is the amount of money you spend out of pocket before your prescription drug benefits begin. Your plan may or may not have a deductible. The maximum deductible a plan can charge for 2020 is set at $435. It has increased by $20 from 2019. Part D

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Benefit Period

The benefit period is the length of time during which a benefit is paid. It measures your use of inpatient hospital and skilled nursing facility (SNF) services. This begins the day you are admitted as an inpatient, or to an SNF, and ends the day you have been out of the hospital or SNF for 60 days in a row. After you meet your deductible , Original Medicare will pay in full for days 1 to 60 that you are in a hospital. The remaining days, 61-90 , you will have to pay a daily coinsurance. If your 90 days of hospital coverage has been consumed but you need to stay longer, Medicare covers up to 60 additional lifetime reserve days and yo u will also have to pay a daily coinsurance . These days are nonrenewable , meaning you will not get them back when you become eligible for another benefit period. If you run out of days during your benefit period, Medicare will stop paying for your in-patient related hospital costs such as room and board. To be eligible for a new b

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Comparing Health Care Providers

How do I compare the quality fo Health Care Providers? Medicare collects information about the quality and safety of medical care and services given by most health care providers (and facilities). Check Medicare.gov/quality-care-finder and get a snapshot of the quality of care they give their patients. Some feature a star rating system to help you compare quality measures that are important to you. Find out more by: Talking to your health care provider. Each health care provider should have someone you can talk to about quality. Asking your doctor or other health care provider what he or she thinks about the quality of care other providers give. You can also ask your doctor or other health care provider about the quality of care information you find on Medicare.gov . Having access to quality and cost information upfront helps you get a complete picture of your health care options. You'll be able to compare quality ratings, cost information, and other details to hel

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