What is a Medicare Cost Plan?

Cost plans are largely unique to Minnesota — and worth knowing about if you live in the right county.  Medicare Cost plans are not available everywhere.

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Minnesota counties where Cost plans are currently available:

Aitkin, Carlton, Cook, Goodhue, Itasca, Kanabec, Koochiching, Lake, Le Sueur, McLeod, Meeker, Mille Lacs, Pine, Pipestone, Rice, Rock, Sibley, St. Louis, Stevens, Traverse, Yellow Medicine

If your county is not on this list, a Cost plan is not an option for you — but we can help you find the right alternative.

County availability may change from year to year. [Contact us] to confirm current availability in your area.

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What Is a Medicare Cost Plan?

A Medicare Cost plan is a type of Medicare health plan offered by a private insurance carrier that contracts with Medicare. Like Medicare Advantage, it combines your hospital and medical coverage into one plan and may include prescription drug coverage. Or, you can choose a Cost plan without drug coverage and add a standalone Part D plan.

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What makes Cost plans different is how they handle care received outside the plan's network.

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The Original Medicare Fallback

With a Medicare Advantage plan, going outside the plan's network typically means paying significantly more — or, with some HMO plans, paying the full cost of care yourself.

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A Cost plan works differently. If you receive care from a provider who does not participate in the Cost plan's network, your care is covered under Original Medicare instead. Medicare becomes the payer, and you are responsible for standard Medicare cost-sharing — the same deductibles and coinsurance that apply to Original Medicare. You are not left without coverage simply because a provider is out of network.

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This flexibility can be meaningful for people who travel, split time between locations, or want access to providers outside a defined network without fully stepping away from managed care.

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How It Compares to Medicare Advantage

Both Cost plans and Medicare Advantage plans are offered through private carriers and provide Medicare-covered benefits in one place. The key difference is network flexibility. Medicare Advantage plans require you to work within a network for most covered care. Cost plans allow you to step outside that network and fall back on Original Medicare when needed — though doing so means accepting Original Medicare's cost-sharing rather than the plan's.

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Our Role

If you live in a county where Cost plans are available, we can help you compare your options — including Cost plans, Medicare Advantage, and Medicare Supplement — based on your providers, your prescriptions, and how you use your coverage. There is no cost to work with us. We are paid by the carriers, not by you. Contact us to get started.

Cost plan availability and benefits vary by carrier and county and may change annually. Contact us or visit Medicare.gov to confirm current options in your area.

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