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June 26, 2024

So, when it comes to understanding health plan costs, there are a few things you should keep in mind. Your costs can vary based on factors like the plan you choose and the services you receive. If you're interested in a specific plan, you can get detailed cost information for that plan.

First off, let's talk about premiums. This is a monthly amount you pay for coverage, whether you use services or not. If you join a plan with a premium, you'll pay it in addition to your Part B and Part A premiums if you don't have premium-free Part A coverage.

Next up, we have deductibles and copayments. The deductible is the amount you must pay for healthcare or prescriptions before your insurance kicks in. Copayments are the fixed amounts you may need to pay after deductibles. Remember, these amounts can vary from those under Original Medicare.

Additionally, factors like whether you follow the plan’s rules, use in-network providers, or receive extra benefits can affect what you pay. The plan sets the amounts for premiums, deductibles, and services each year, and only they can change what you pay for covered services.

It’s also worth noting that having other health coverage, being on Medicaid, or getting state assistance can impact your costs. If you're curious about how Medicare works when you have multiple types of coverage, you can reach out to Lehigh Partners about the Plans you're interested in for more details.

Your expenses can differ depending on factors like the specific plan you enroll in and the services you receive. For detailed cost information on a plan that piques your interest, reach out to learn more.

Medicare Health Plan Costs

Things to consider


If the plan charges a premium

If you join a plan that charges a premium, you pay this in addition to the Part B premium (and the Part A premium if you don't have premium-free Part A).

If the plan has a yearly deductible and copayment

These amounts can be different from those under Original Medicare. Each year, plans set the amounts they charge for premiums, deductibles, and services. The plan (rather than Medicare) decides how much you pay for the covered services you get. What you pay the plan can only change once a year, on January 1.

If your doctor, provider, or supplier accepts assignment

If your doctor, provider, or supplier accepts assignment:

  • Your out-of-pocket costs may be less.
  • They agree to charge you only the Medicare deductible and coinsurance amount and usually wait for Medicare to pay its share before asking you to pay your share.
  • They have to submit your claim directly to Medicare and can’t charge you for submitting the claim.

Other factors that might affect what you pay


  • Whether you follow the plan's rules, like using in-network providers.
  • If the plan offers extra benefits and what they charge for them.
  • The plan's yearly limit on your out-of-pocket costs for all medical services.
  • Whether you have Medicaid or get help from your state.
  • The type of plan you have.
  • The services you need and how often you get them.
  • If have other health coverage.

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Talk to us: (833) 265-9655 

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