Medicare Plans

Are There Other Kinds of Medicare Health Plans?

Other Medicare Health Plans

Some types of Medicare health plans that provide health care coverage aren't Medicare Advantage Plans but are still part of Medicare. Some of these plans provide Part A (Hospital Insurance) and/or Part B (Medical Insurance) coverage, and some also provide Part D (Medicare prescription drug coverage). These plans have some of the same rules as Medicare Advantage Plans. Some of these rules are explained briefly below. However, each type of plan has special rules and exceptions, so you should contact any plans you're interested in to get more details.

Medicare Cost Plans

Medicare Cost Plans are a type of Medicare health plan available in certain areas of the country. Here's what you should know about Medicare Cost Plans:

• You can join even if you only have Part B.
• If you go to a non-network provider, the services are covered under Original Medicare.
• You would pay the Part B premium, and the Part A and Part B coinsurance and deductibles.
• You can join anytime the plan is accepting new members.
• You can leave anytime and return to Original Medicare.
• You can either get your Medicare prescription drug coverage from the plan (if offered), or you can join a Medicare Prescription Drug Plan to add prescription drug coverage.

There is another type of Medicare Cost Plan that only provides coverage for Part B services. These plans never include Part D. Part A services are covered through Original Medicare. These plans are either sponsored by employer or union group health plans or offered by companies that don't provide Part A services.

Demonstrations/Pilot Programs

Demonstrations and pilot programs, sometimes called "research studies," are special projects that test improvements in Medicare coverage, payment, and quality of care. They usually operate only for a limited time for a specific group of people and/or are offered only in specific areas. Check with the demonstration or pilot program for more information about how it works.

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

PACE combines medical, social, and long-term care services, and prescription drug coverage for frail elderly and disabled people. This program provides community-based care and services to people who otherwise need a nursing home-level of care. To qualify for PACE, you must meet the following conditions:

• You are age 55 or older.
• You live in the service area of a PACE organization.
• You are certified by your state as meeting the need for a nursing home-level of care.
• At the time you join, you are able to live safely in the community with the help of PACE services.

PACE uses Medicare and Medicaid funds to cover all of your medically necessary care and services. You can have either Medicare or Medicaid or both to join PACE. Call your State Medical Assistance (Medicaid) office to find out if you are eligible and if there is a PACE site near you.

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• When Do I Sign Up for Medicare Parts A & B?
• How Much are Medicare Premiums, Deductibles and Coinsurance Rates?
• Can I Choose Medicare Advantage (Part C) Instead of Medicare Parts A & B?
• Medicare Advantage Plan Types and Enrollment Periods
• Are There Other Kinds of Medicare Health Plans?
• What Are My Options for Medicare Prescription Drug Coverage (Part D)?
• What Are Medigap (Medicare Supplement Insurance) Policies?
• Changes Made to Medigap Plans on June 1st, 2010
• Changes Made to Medigap Plans on January 1st, 2020