What is a Medicare Cost plan? | Medicare Part D Guide

A Medicare Cost plan, according to the Centers for Medicare and Medicaid (CMS) is defined as:

A type of [Medicare Advantage] HMO. These plans may work in much the same way, and have some of the same rules, as Medicare Advantage plans. In a Medicare Cost Plan, if you go to a non-network provider, the services are covered under the Original Medicare Plan. You would pay the Medicare Part A and Part B coinsurance and deductibles.

A Medicare Cost plan can include Medicare Part D drug coverage (MAPD) or a separate stand-alone Medicare Part D prescription drug plan (PDP) can be added to a Cost plan.

The CMS Medicare & You document adds more information about Medicare Cost plans:

• In general, you can join even if you only have Part B.
• If you have Part A and Part B and go to a non-network provider, Original Medicare covers the services. You’ll pay the Part A and Part B coinsurance and deductibles.
• You can join anytime the Medicare Cost Plan is accepting new members.
• You can leave anytime and return to Original Medicare.
• You can get your Medicare drug coverage from either the Medicare Cost Plan (if offered) or you can join a Medicare drug plan. Even if the Medicare Cost Plan offers drug coverage, you can choose to get drug coverage from a separate Medicare drug plan.

Note: You can add or drop Medicare drug coverage only at certain times

Please also note: Medicare Cost Plans are available only on a limited basis

The availability of Medicare Cost plans across the country remains limited, with 50 Medicare Cost Plans offered in 2025, down from 57 plans in 2024 (out of approximately 5,218 Medicare Advantage plans offered in 2025).

See our article: "The number of 2025 Medicare Advantage plan choices decrease" - found at on this site Finding a Medicare Cost Plan in your area

You can see all Medicare Cost Plans in your area by using our Medicare Advantage Plan Finder (MA-Finder.com).

Begin by entering your ZIP code (click on the "Click to Find Plans" ) - selecting your county (if your ZIP code includes more than one county) - and then using the "Health Coverage Type" filter, selecting "Cost Plans".

Here is a 2023 example of two Medicare Cost Plans available in Columbia county, Wisconsin.

MA-Finder showing an example of all Medicare Cost plans in a selected ZIP Code or country Service Area

(sources include: Medicare.gov and 2021 Medicare & You Handbook)