Medicare Advantage (Medicare Part C) $0 Premium Plans
Medicare Advantage, also known as Medicare Part C, is one way through which Medicare beneficiaries can bundle prescription drug coverage along with their Medicare Part A and Part B benefits. Medicare Advantage plans may in some cases include additional coverage such as vision, dental, or health and wellness programs.
Depending on an individual's place of residence and plan availability, Medicare beneficiaries can apply for Medicare Advantage plans that have little to no monthly premiums. These plans can be referred to as Medicare Advantage $0 premium plans.
Medicare Advantage plans are approved by Medicare and are offered by private insurance companies. Hence, these companies must follow regulations set by the Medicare program. In return, Medicare pays a fixed monthly amount for each Medicare beneficiary's health care to all companies offering Medicare Advantage plans. This amount may be sufficient for an insurance company to offer a Medicare Advantage plan with a $0 monthly premium.
Costs Associated with $0 Premium Medicare Advantage Plans
Although it may seem like there are no costs to a $0 Medicare Advantage plan, there are several expense categories to keep in mind for any Medicare Advantage plan:
Medicare Part B Premium: People enrolled in Medicare Advantage are still responsible for their Medicare Part B premiums regardless of the monthly premium of the Medicare Advantage plan. Medicare beneficiaries must pay out-of-pocket for their monthly Medicare Part B premium which ranges from $104.90 to $335.70 depending on yearly income.
Deductibles: Some Medicare Advantage plans have a deductible that must be satisfied prior to the plan paying costs. Medicare sets the maximum possible deductible for Medicare Advantage plans annually. However, many plans reduce the amount of the deductible.
Copayments: Copayments are amounts that Medicare beneficiaries pay as their share of the health care costs while the insurance company pays for the remaining costs. $0 premium Medicare Advantage plans charge copayments just as Medicare Advantage plans with monthly premiums do.
Prescription Drug Costs: Every Medicare Advantage plan has a different list of drugs they will cover and different out-of-pocket expenses for those drugs. Given that the amount and combination of drugs taken varies by individual, it is important to select a plan that results in the most drug coverage and lowest out-of-pocket costs based on individual prescription drug needs. Please note that some Medicare beneficiaries can qualify for the Extra Help, also known as the Low Income Subsidy, program for help on their prescription drug costs.
Just because a Medicare Advantage plan offers a $0 premium charge does not mean that the plan is free or that Medicare beneficiaries will not accrue out-of-pocket costs. In some cases, a Medicare Advantage plan that charges a premium, yet offers a lower deductible, lower copayment amounts, and a more comprehensive drug coverage, could be a better option that a Medicare Advantage $0 premium plan with a high deductible, high copayment amounts, and drug coverage that does not cover the prescription drugs the individual needs.
Future of Medicare Advantage $0 Premium Plans
Changes to healthcare legislation may someday affect the availability of $0 premium Medicare Advantage plans. If Medicare Advantage subsidies are cut, the insurance companies may pass their increased costs on to people enrolled in the Medicare Advantage plans and a premium may be charged to compensate for the revenue lost in Medicare payments from the government.
It is important for Medicare beneficiaries to compare Medicare Advantage plans available in their area every year during certain Medicare enrollment periods. A Medicare Advantage plan option with $0 premium one year may not necessarily mean the same no premium charge will be carried over next year.
Medicare Advantage Plans, sometimes called "Part C" or "MA Plans," are offered by private companies approved by Medicare and provide Medicare Part A and Part B coverage. Medicare prescription drug coverage is insurance run by an insurance company or other private company approved by Medicare. A Medicare Supplement plan is a health insurance plan provided by a private company that fills in the "gaps" in original Medicare coverage.
Medicare has neither reviewed nor endorsed this information.