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Medicare cost plans are a type of HMO that contracts as a Medicare Health Plan. As with other HMOs, the Medicare Cost plan only pays for services outside its service area when they are emergency or urgently needed services. If a Medicare beneficiary enrolled in a Medicare Cost Plan gets any routine services outside of the plan's network without a referral, the Medicare-covered services will be paid for under Original Medicare, and the patient will be responsible for the Original Medicare deductibles and coinsurance.
- Browse Related Terms: Exclusive Provider Organization (EPO) Plan, Health Maintenance Organization, Health Maintenance Organization (HMO), In-Network provider, Managed Care, Medicare Advantage, Medicare Advantage (Medicare Part C), Medicare Cost Plans, Medicare Select Plans, Out-of-network provider, Point of Service (POS) Plans, Point-of-Service Plan (POS), Preferred Provider Organization (PPO), Primary Care Physician (PCP), Referral, Third-Party Payer