Nearly half of all Medicare beneficiaries (28 million people) are enrolled in a Medicare Advantage plan as of 2022.

Medicare Advantage helps beneficiaries of Original Medicare Parts A & B cope with the additional out-of-pocket costs associated with their healthcare.

If you search online forums, you might see people discussing how you can get a free, zero-premium Medicare Advantage plan – Is that a real thing? Since when do companies give anything away for free?

Well, it’s true. Some Medicare Advantage policies come with zero monthly premiums, meaning you don’t have to pay anything to enroll or remain enrolled in the scheme.

How can Medicare Supplement plans cost nothing? Is there a catch to it, and why doesn’t everyone do it?

There is something of a “catch” involved with a zero-premium MA plan. You’ll still have to make copayments, coinsurance, and deductible payments to remain enrolled.

In this post, we’ll discuss the specifics of zero-premium Medicare Advantage plans and how to get one if it’s available in your state.

The Medicare Advantage plan, also known as Medicare “Part C,” allows Medicare-approved private providers (healthcare companies) to offer policies providing beneficiaries their Part A & B benefits associated with Original Medicare.

Therefore, a zero-premium MA plan, like other MA plans offering no copays, may include coverage for prescription medications. Plans may also cover additional healthcare costs, like dental services.

The Federal Medicare program pays private healthcare insurance companies a fixed amount to provide their clients with Original Medicare Parts A & B.

Any funds leftover from these programs go towards funding zero-premium policies for qualifying beneficiaries.

Medicare Advantage zero premium plans have specific rules regarding Medicare costs.

However, some providers have flexibility in setting cost-sharing amounts and premiums. The same applies to Medicare Advantage plans.

Most Medicare Advantage plans include coverage for prescription medications (MA-PDs).

The share of MA-PDs charging zero premiums (other than the premium for Part B) increased from 59% to 66% for 2023.

Additionally, 17% of Medicare Advantage plans have some level of reduction in Part B premiums in 2023. 99% of beneficiaries also have access to MA-PD plans featuring zero monthly premiums in 2023.

However, it’s important to note residents of Alaska don’t have any access to zero-premium MA-PDs.

The CMS announced that the average monthly plan premium was expected to be $18 per month for all Medicare Advantage beneficiaries in 2023.

This includes beneficiaries paying no premiums for their Medicare Advantage plan.

What are the Other Costs Involved with Free Medicare Advantage Policies?

So, just because a provider offers a zero-premium MA plan in your area doesn’t mean it’s necessarily the best option for a supplemental Medicare plan.

Medicare Advantage plans sometimes come with additional fees, such as:

• deductibles,
• copayments,
• and coinsurance,
• and can feature different additional benefits.

Coinsurance and copayments are cost-sharing programs requiring beneficiaries to pay amounts toward the healthcare services they use. For instance, a MA plan might cover 80% of the cost of visiting your physician for a consultation. In this case, you would have to pay the additional 20% coinsurance charge.

The deductible is the amount you’ll pay annually for healthcare services before the plan activates and begins to cover your medical costs. For instance, if the plan has an annual deductible of $700, and you spend $700 on healthcare services in a year, the deductible amount rests the following year.

So, you could pay $700 out-of-pocket for healthcare costs every year without receiving any benefit from the plan. All plans usually feature copayments, coinsurance, and deductibles, at varying amounts.

Bear this in mind when you’re comparing zero-premium Medicare Advantage plans between providers.

What Else You Need to Know about No-Premium Medicare Advantage Policies

Medicare Advantage plans, unlike Original Medicare, feature out-of-pocket spending limits on your annual healthcare costs. This means that after spending a certain amount on healthcare using your own money, the plan starts to cover all other related medical expenses covered by the policy.

As mentioned, a zero-premium Medicare Advantage plan usually features out-of-pocket Medicare costs you’ll need to pay, such as deductibles, coinsurance, and/or copayments for healthcare services.

Some plans come with provider networks, requiring you to receive care from medical professionals in that network. So, you might be unable to visit your usual doctor for a consultation.

For example, a zero-premium Medicare Advantage plan might have a provider network suiting your healthcare needs.

If you venture outside of this network for healthcare services, you’ll end up paying more out-of-pocket costs associated with your treatments and care.

Zero-premium Medicare Advantage plans feature specific enrollment periods during the year.

Check with your provider for the dates of these enrollment periods. Typically, new members can enroll in a zero-premium Medicare Advantage plan, but you’ll need to pay the monthly Part B premium for Original Medicare.

However, some Medicare Advantage plans charge premiums.

Speak to us, and we’ll guide you through everything you need to know about zero-premium Medicare Advantage plans.