Is Medicare Advantage Free?
No, Medicare Advantage plans are not free.
Although some plans may offer a $0 monthly premium, you are still responsible for paying your Part B premium, as well as any applicable copays and deductibles.
How Can an Advantage Plan Have No Monthly Premium?
An Advantage plan can have no monthly premium due to how the government subsidizes it. Medicare Advantage plans (Part C) are offered by private insurance companies that are paid a fixed amount each month by Medicare.
By subsidizing the costs, these payments make it possible for certain plans to have $0 monthly premiums.
While these plans may have no monthly premium, out-of-pocket expenses may be higher, and provider options may be more limited than other plans.
Costs to Keep In Mind
While $0 Medicare Advantage plans may seem free at first glance, it’s important to understand that they still entail a variety of costs, including:
- Premium for Medicare Part B
- Copays for office visits, ER visits, labwork, and outpatient imaging
- Copay per day for inpatient hospital stays
- Copay or coinsurance for outpatient treatment and outpatient surgery
- Copay or coinsurance for emergency transportation
- Copay or coinsurance for physical therapy
Your expenses in these areas will count towards your plan’s out-of-pocket maximum. Once you reach the maximum limit, copays and coinsurance will no longer be applicable, and the plan will provide 100% coverage for both.
Is Medicare Advantage Worth It?
Deciding if Medicare Advantage is worth it ultimately depends on your personal health needs, budget, and preferences.
Advantage plans frequently offer additional benefits that are not covered by Original Medicare, such as dental, vision, hearing, and prescription drug coverage. These added perks can make Advantage plans a valuable option for Medicare beneficiaries.
Some people may also appreciate the convenience of having all their heath care coverage bundled into one plan.
However, these plans typically restrict you to a network of providers, which can limit your choice of doctors and hospitals. As previously mentioned, although their monthly premiums are lower, they often come with higher deductibles and copays.
What if I Can’t Afford a More Expensive Plan?
If a $0 premium plan is the only option that works for your budget, it’s not a bad choice. Just monitor your out-of-pocket costs and consider upgrading to a more comprehensive plan in the future.
Medicaid can be an option for those who struggle to afford a comprehensive Medicare Advantage plan. This federal government program helps low-income individuals and families cover healthcare costs, including inpatient and outpatient hospital care, laboratory services, home healthcare, and nursing facility services.
Medicaid services are funded jointly by the federal government and individual states. This means that eligibility requirements and covered services may vary slightly depending on the state in which you reside.
Bottom Line
Medicare Advantage plans are not free. Even if the plan has no monthly premium, you will still be responsible for paying your Medicare Part B premium.
Additionally, some plans may have co-payments or deductibles for certain services.
If you need help choosing a plan, we’re here to assist you in comparing costs, coverage, and network options.
Sources: Medicare.gov | AP News | Humana
FAQs
What are the negatives of a $0 Medicare Advantage plan?
A $0 premium plan may offer limited benefits or have higher copays and deductibles than plans with a monthly premium.
Are there $0 Medicare Supplement plans?
No. Medicare Supplement insurance plans are not available with a $0 premium – you will need to pay a monthly premium for these plans in addition to your Part B premium.
Is Original Medicare free?
Traditional Medicare has an associated Part B premium that must be paid monthly.
