Cost sharing plans help cover out-of-pocket costs for Original Medicare benefits. The 50% Cost Sharing plan only requires you to pay half of the costs left over after Medicare covers their portion.
Coverage
The 50% Cost Sharing Plan offers full coverage (100% of costs paid) for Medicare Part A coinsurance and 50% coverage for several other out-of-pocket expenses. The other benefits featured in this plan include:
- Medicare Part A deductible: 50% covered
- Medicare Part A hospice care copayments: 50% covered
- Medicare Part A hospice care coinsurance: 50% covered
- Medicare Part B coinsurance: 50% covered
- Medicare Part B copayments: 50% covered
- Skilled nursing facility costs: 50% covered
The plan will also pay 50% of the first 3 pints of blood that you need. After the first 3 pints, the entire cost is covered directly by Original Medicare.
It does not cover Medicare Part B deductibles or excess charges.
Cite: Medicare.gov
Annual Limit
There is an annual limit on cost-sharing intended to prevent excessive out-of-pocket costs for beneficiaries. After this limit is reached, your plan will cover the full cost (100%) of the featured benefits for the rest of the year. As of 2023, the out-of-pocket limit is $6,940.[1] This limit changes annually.
Cite: Medicare.gov
Choosing A Cost Sharing Plan
Cost sharing plan benefits are generally standardized across most states, therefore regardless of where you are located and who you purchase your plan from, the benefits will be the same.
Choosing a plan that suits your specific needs can be difficult if done independently. Contact Grutz Financial for assistance in this complex process.
References
1. https://www.cms.gov/medicare/health-plans/medigap/kandl; Published: Sep 30, 2022; Accessed: Nov 17, 2022
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