An insurance carrier replaces Medicare and becomes your primary payer, offering healthcare services actuarially equivalent to Original Medicare (80/20) through a network of providers where, one doctor becomes your Primary Care Provider.
Like Original Medicare, certain benefits require you to pay hospital and medical deductibles, co-pays and/or co-insurance. Unlike Original Medicare where the 20% copay is unlimited, MAPD plans have a maximum out-of-pocket (MOOP), typically $6,700