Paying Now vs. Paying As You Go

What you pay out of your own pocket and when you pay it depends on which coverage option you choose.

For example, if you choose to add a Medicare supplement to Original Medicare, you’re paying upfront through a monthly premium regardless of whether you see the doctor or go into the hospital.

With Original Medicare, you “pay as you go” by paying 20 percent coinsurance. If you need more extensive medical care however, there’s no limit on what you’ll have to pay out of your own pocket each year.

Many Medicare Advantage plans offer $0 premium plans where you “pay as you go” through small copays or coinsurance amounts and only pay for the care you use. The most important thing to note about a Medicare Advantage plan is that, unlike Original Medicare, it also offers an added layer of protection by limiting the amount you pay out of pocket for covered services each year. That way, you’re covered throughout the year, and your savings and retirement are protected should a serious illness or injury occur.

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BayCarePlus Medicare Advantage (HMO) Plan?

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Important Disclaimers

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BayCare Select Health Plans is an HMO plan with a Medicare contract. Enrollment in BayCare Select Health Plans depends on contract renewal. All BayCare Select Health Plans include Part D drug coverage.

To enroll, you must have both Medicare Parts A and B and reside in the plan service area.

You must continue to pay your Medicare Part B premium. Enrollment in a BayCare Select Health Plan may be limited to specific times of the year.

Members must use plan providers except in emergency or urgent care situations. If a member obtains care from an out-of-network provider without prior approval from BayCare Select Health Plans, neither Medicare nor BayCare Select Health Plans will be responsible for the costs.

Information on our utilization management processes, including prior authorization, concurrent review, post service review and appeals, can be found online at Member.BayCarePlus.org.

Every year, Medicare evaluates plans based on a 5-star rating system.

BayCare Select Health Plans complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

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