Please note that this site is a free public service and is not an endorsement for any Medicare health plan or product.

Costshare Report FAQs

Exactly what do the COSTSHARE REPORT findings represent?

The findings do represent how cost-sharing (out-of-pocket expenses) can vary among Medicare managed care plans that offer similar benefits and services when adjusted for enrollee health status.

The findings do represent the out-of-pocket expenses for the most common services that Medicare beneficiaries utilize, e.g., physician office visits, emergency/urgent care, prescriptions, routine preventative care, inpatient hospital care.

The findings do compare plans based on the applicable annual out-of-pocket expenses (copayments, premiums, deductibles) that enrollees incur for selected benefits and services provided under each plan.

The findings do represent each plan's cost-sharing requirements from the Medicare Compare Database.

What do the COSTSHARE REPORT findings not represent?

The findings do not represent a guarantee of the actual annual out-of-pocket expenses that Medicare beneficiaries would incur upon enrolling in a plan.

The findings do not include other annual out-of-pocket expenses that may apply for other plan benefits and services that may also be utilized, e.g., mental health care, chiropractic care, podiatry care, home health visits, medical equipment, ambulance transportation.

The findings do not compare provider networks, financial stability, quality of care, enrollee satisfaction, or other managed care plan performance measurements.

The findings do not represent the cost-sharing requirements for Medicare beneficiaries enrolled in employer-sponsored group retirement plans.

What limitations should Medicare beneficiaries take into consideration when using the COSTSHARE REPORT findings?

COSTSHARE REPORT findings have been verified for accuracy by each plan.  Nevertheless, certain limitations or benefit restrictions may apply that can affect the annual out-of-pocket expenses shown in the COSTSHARE REPORT examples.

Plan benefits, copayments, deductibles, and monthly premiums are subject to change by the Center for Medicare & Medicaid Services (CMS).

Medicare Part B premiums ($96.40 minimum per month in 2009) are not included in the cost-sharing comparisons but must continue to be paid as a condition for enrollment in all Medicare managed care plans.

Cost-sharing dollar differences between individual plans may range from as little as $1 to over $500.  Each COSTSHARE REPORT user should decide whether the annual cost-sharing dollar differences are sufficient for selecting one plan over another.

Although COSTSHARE REPORT comparisons are important, they should not be the sole basis for either selecting or not selecting a Medicare managed care plan.
Back to Medicare Advantage Cost Share Reports