No.
There’s no such thing as a free lunch. There’s no such thing as a free Medicare Advantage plan.
In this video, we explain how those zero dollar plans work, how it’s possible for plans to operate without a monthly fee, and how to figure out whether a zero dollar premium Medicare Advantage plan is right for you.
Confused about your Medicare coverage options? Watch our free video: How to Find the Best Medicare Coverage Without Paying More Than You Need To…
$0 Premium Medicare Advantage Plans Costs
If you enroll in a zero dollar premium Medicare Advantage plan, that means you won’t have to pay the plan any monthly charge to stay enrolled. It’s $0 per month to be in that Medicare Advantage plan.
Part B Premium
However, you still have to pay your Medicare Part B monthly premium to Medicare, which for most people is $148.50 per month in 2021. The Part B premium is income-dependent, so here is a link to a video that will help you figure out your Medicare Part B monthly premium if you have high income.
Deductibles, Copays, Coinsurance
If you enroll in a zero dollar premium Medicare Advantage plan, you won’t have a monthly fee to be part of the plan, but what if you have a doctor visit or fill a prescription or have surgery or other medical procedures performed?
If it’s anything other than preventive care covered at 100% by Medicare, you will have charges in the form of deductibles, copays, and coinsurance when you access healthcare.
Those copays can be very low. Some plans have $0 copays if you are seeing your primary care physician. On the other end of the spectrum, copays and coinsurance amounts can be up to several hundred dollars if you are hospitalized or having major surgery.
The same is true for medications. Some inexpensive generic drugs can be filled with a $0 copay, while very expensive brand name drugs have much higher costs.
All of the copay and coinsurance amounts are available in plan documents and should be considered before you enroll in a plan.
Maximum Out-Of-Pocket Limit
Because copays and coinsurance can really add up if you need a lot of medical care during the year, every Medicare Advantage plan has to have a Maximum Out-Of-Pocket limit for the calendar year.
This limit is as much as you will have to pay during a year, as long as all of your medical treatment is covered by your plan and uses in network providers.
The Maximum Out-Of-Pocket limit varies from plan to plan, so this is another item to compare when you are looking at Medicare Advantage options.
Plan Networks
When looking at Medicare Advantage plan costs, the plan networks also have to be considered. Some Medicare Advantage plans don’t cover anything done out of network. Others have some out of network coverage, but it is always going to cost you more than using in network providers.
Even though the plans charge copays and coinsurance for medical services and prescriptions, how can they afford to stay in business without monthly fees from enrollees?
You paid into Medicare your whole working life through taxes to pay for your Medicare Part A inpatient coverage. Once you enroll in Medicare Part B, you pay your Part B monthly premium the entire time you are enrolled.
If you enroll in a Medicare Advantage plan, Medicare will pay your plan a set amount every month to manage your care. That’s how some Medicare Advantage plans can function without charging members a monthly fee to be enrolled in the plan.
How do you decide if a zero dollar Medicare Advantage plan is right for you?
First, look at your situation.
Are you pretty healthy?
Do you only have a few doctor visits during a typical year?
Do you take a few generic medications or no medications at all?
Do you have enough money set aside just in case you would have a year with high medical expenses and reach a plan’s maximum out-of-pocket limit?
If you answered “yes” to all of those questions, it is definitely worth your time to look at Medicare Advantage plans.
Even if you couldn’t answer “yes” to all those questions, it’s still worth it to take a look at what’s available for Medicare Advantage plans in your zip code.
They can change every year, so during the Annual Enrollment Period, from October 15 through December 7, see if any plans in your area have changed or if new plans have been introduced.
If you have a chronic medical condition or are dual Medicare and Medicaid eligible, there are also Medicare Advantage plans specifically designed for you that may lower your overall medical costs.
Here’s a quick list of things to check when looking at Medicare Advantage plans:
- Are your medical providers and pharmacies in network?
- Are your prescription medications covered?
- What is the overall estimated cost for the year for your care?
Have questions? We can help!
Making a comparison of all the plans available can be complicated and time-consuming. Fortunately, you don’t have to go it alone!
A Medicare plan broker will objectively compare all available plans, and if there’s one that’s right for you, help you enroll.
Plus, brokers remain in your corner after the enrollment to answer any questions that come up and help you do the same comparison search in future years.
If you would like to look at Medicare Advantage plans in your zip code, please feel free to give our office a call at 877-312-1414 or schedule a free, no obligation Medicare Plan Consultation. We’re here to help you find the best Medicare coverage for your unique situation.
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