1Amount shown does not include Medicare Part B premium, which you must continue to pay if not otherwise paid for under Medicaid or by another third party. Beneficiaries who qualify for extra help may pay a lower monthly plan premium. For more information, see Paying for Medicare.
2Numbers shown in this table reflect in-network copayments. Depending on the type of plan you choose, if you obtain care from out-of-network providers, those services may not be covered by the plan or you may have to pay higher copayments/coinsurance than shown here. See a plan's Evidence of Coverage for specific copayments or coinsurance.
3Amounts may vary depending on the level of care provided or the type of health care services you receive.
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