What you pay in a Medicare Medical Savings Account (MSA) plan
Question 4 of 6 (use "Last" or "Next" buttons to see more)
Last Update: April 03, 2012
In a Medicare Medical Savings Account (MSA) plan, you still pay the Part B premium. You generally will not have to pay an additional premium for the plan. You will only have a separate premium to pay if your plan offers supplemental benefits (like vision or dental care) that you choose to buy. If your plan offers supplemental benefits, you always have a choice of whether or not to take them.
If you are in an MSA plan, the plan will deposit a certain amount of money in an account at a bank of its choosing. This account is called a Medical Savings Account. You can use the money in this account to pay for medical services. Your costs for services will be different depending on:
- Whether you are in your deductible period or coverage period.
- Before you have reached your deductible (the amount you must pay out of pocket before your coverage begins) you pay the full cost of Medicare-covered services. Your MSA plan deductible can be as high as $10,600 in 2012.
- If you enroll in an MSA after January 1, your yearly deductible will be prorated to the number of months left in the year. For example, if you enroll in an MSA that becomes effective September 1, and the plan has a yearly deductible of $6,000, then your deductible for the rest of that year will be $2,000. (Because you’ll only be in the plan for 1/3 of the year, you pay 1/3 of the cost of the deductible. The amount deposited in your Medical Savings Account will also be prorated.)
- Which providers you use.
- If your MSA plan has a provider network, you pay the least when you see in-network providers.
- If your MSA plan doesn’t have a provider network, you pay the least when you see doctors who take assignment, also called participating providers. Doctors who take assignment have agreed to take Medicare’s approved amount as payment in full. When you see one of these providers before you meet your deductible, you will be charged the full Medicare-approved amount, which will count toward meeting your deductible. To find participating providers, you can call your plan or 800-MEDICARE, or go to Medicare.gov.
- If you see a non-participating provider, you may have to pay up to 15 percent more than the Medicare-approved amount, depending on the rules for non-participating providers in your state. Non-participating providers accept Medicare but aren’t required to take Medicare’s approved amount as full payment and can charge a certain percentage more. When you see one of these providers before you meet your deductible, the Medicare-approved amount plus the extra charge (called a limiting charge) counts toward meeting your deductible.
*Once you meet your deductible and have coverage, you pay nothing for Medicare-covered hospital and medical services (covered by Parts A or B) that you get from providers who accept Medicare.