Not sure what plan is right for you? Take Our Medicare Quiz

Request A Quote

Speak to an advisor

866-MEDIGAP (633-4427)

TTY: Dial 711

Email Us

Not sure what plan is right for you? Take Our Medicare Quiz

Medicare Advantage Plans: Example of Costs for Deductible, Copays, Coinsurance and more.


Medicare Advantage plans generally have low to $0 premium; however, you can’t just look at premium costs. These plans have a “pay as you go” for services provided. We will review the some of your most expensive costs of an individual who wants a PPO plan and is living in zip code 32780. All costs assume in network fees:

  • Maximum out of Pocket: Between $5,900 and $6,700. $10,000 maximum for in and out of network services
  • Primary Care Visit: Between $5 and $25
  • Specialist Visit: Between $35 and $50
  • Urgent Care: Between $30 and $65
  • Emergency Room Visit: $90 – this fee is waived if you are admitted
  • Ambulance: Between $240 and $250
  • Skilled Nursing Facility: $160 for days 21 -57 or $167 for days 21-100
  • Inpatient hospital care: $270 for days 1-8 or $625 for days 1-3
  • Outpatient surgery: Between $270 and $390
  • Diagnostic tests (lab, radiology and x-rays): Between $0 and $110
  • Chemotherapy or any Part B infusion drug: 20% coinsurance
  • Annual drug deductible: Between $150 and $395

These plans do include: Prescription drug plans, fitness programs and some dental, vision and hearing.


Are you considering a Medicare Advantage Plan?

If you are considering a Medicare Advantage Plan, call us at 866-MEDIGAP or 866-633-4427 and let our licensed Medicare specialist help you to ensure the plan you want is the best plan in your area for you. We will review all the plans available in your area, give you a side-by-side comparison to help you decide which plan is best for you and guide you through the enrollment process. Our services are 100% free to you! Included with our comparison is:

1. Compare Plan Types: HMO, PPO, PFFS, POS, or SNP.

2. Compare Plan Costs: Costs vary by plan premium, copays, coinsurance and maximum out-of- pocket (MOO) costs.

3. Compare Additional Benefits Offered: Prescription drug plans, fitness programs, dental, vision and hearing and other extra benefits available.

4. Compare Network Size: Are all my doctors in network? What hospitals and facilities are in network?

5. Compare Travel Restrictions.

6. Compare Referral Policies.

Learn More: How do I compare all the different Medicare Advantage Plans?

People Also Read: What are Medicare Enrollment Periods?

Meet Melissa MacCalla

Medicare is not simple and can be hard, frustrating, and downright confusing for most. I love when I get someone on the phone and I am given the opportunity to explain the difference in plans to them and have Medicare make sense. I enjoy talking to clients year after year, hearing about their families growing or them asking about mine.


Senior Healthcare Solutions, you truly stand out from most other insurance agents. Thank you so much for all of your help and I know that you will have nothing but success with how you conduct business.

Joan B.

Montgomery, AL

Other posts you may interested in…