In the vast realm of Medicare, understanding different plans and their premiums can be a challenge. But what if we told you there are Medicare plans that could potentially carry a zero-dollar premium?
These plans exist but for you to understand one key component that is true for all plans no matter if they are called zero premium or plans that ones have a monthly premium (hint: it has to do with Medicare Part B).
This blog post will break down the key information about these plans, demystify how they work, and help you determine if they are the right choice for you.
What is a Medicare Zero Premium Plan?
You might be wondering, "How can a Medicare plan have no premium?" To understand this, let's first unpack what Medicare Zero Premium Plans are. These are a type of Medicare Advantage Plan, provided by private insurance companies. They offer the same coverage as Original Medicare (Part A and Part B) and may include additional benefits such as prescription drug coverage, dental, vision, and wellness programs.
The "zero premium" part means that these plans don't require you to pay a monthly premium. But this doesn't mean that the plan is entirely free. You still have to pay for the deductibles, copayments, and coinsurance that your plan may require.
How Can Medicare Advantage Zero Premium Plans Be Free?
You might be thinking, "How can these plans be free?" The federal government pays private insurers (aka insurance companies) a certain amount for each person who enrolls in a Medicare Advantage plan. This allows each insurance company to use this pool of money to offer plans with no monthly premium or provide additional benefits to its Medicare beneficiaries.
Depending on the Plan Type HMO vs. PPO, you may have additional requirements such as a seeing in network providers for your health coverage needs. You can check if your preferred primary care physician is in a plan when choosing a potential plan.
How is Medicare Part B Premium Deducted from Your Social Security Check?
Part B Medicare is required by law to be paid each month and normally comes out of your Social Security check.
You may be wondering, "How is the Medicare Part B premium deducted from my Social Security check?" This process is quite straightforward and happens automatically once you're enrolled in Medicare Part B and receiving Social Security benefits.
Medicare Part B helps cover medically necessary services like doctors' services, outpatient care, home health services, and other medical services. The standard monthly premium for Medicare Part B can change every year.
If you receive Social Security benefits, the cost of your Medicare Part B premium is typically automatically deducted from your monthly benefit payment. This process ensures that your premium gets paid on time each month, eliminating the need for you to manually pay the bill.
Your Social Security benefits statement, also known as your Social Security 1099 form or Benefit Statement, will show the total amount of your benefits and the total amount deducted for your Part B premium for the previous year.
Keep in mind that the exact amount you pay can vary. Some people may pay a higher premium for Part B if their income is above a certain amount. Also, if you are not receiving Social Security benefits, you will receive a bill for your Part B premium every 3 months.
Unlike other Medigap or Medicare Advantage plans, a ZERO premium Medicare Advantage Plan doesn't take any additional monthly premium payments from you.
What Do Zero Premium Medicare Advantage Plans Cover?
Now, you may be asking, "What exactly does a Medicare Advantage Zero Premium Plan cover?" The coverage varies from plan to plan, but all Medicare Advantage Plans, including those with zero premiums, must cover at least everything Original Medicare does, which means hospital and medical insurance.
Many of these plans will also include prescription drug plans as well.
Some Zero Premium Medicare Advantage Plans also provide additional benefits not covered by Original Medicare, like routine vision and dental care, hearing aids, and wellness programs.
Check with each plan to see what the maximum out of pocket costs will be through these plans.
Who Is Eligible for a Medicare Zero Premium Plan?
Next, "Who can benefit from a Medicare Zero Premium Plan?" The eligibility for these plans is the same as for any other Medicare Advantage Plan. You must be enrolled in Medicare Part A and Part B coverage and live in the plan's service area.
If you have moved to a new area or qualify for another (Special Enrollment Period) SEP such as having Medicaid, you may be eligible to change your plan each quarter throughout the year.
You may also need to choose a primary care physician in the plan's network.
How to Find and Enroll in a Zero Premium Medicare Advantage Plan?
"So, how do I find and enroll in one of these plans?" The best time to join a Medicare Advantage Plan is during the Initial Enrollment Period when you first get Medicare. You are eligible to join 3 months before your 65th birthday month or up to 3 months after.
If you qualify through a disability you'll be eligible for an earlier enrollment if you have worked the required number of quarters.
You can also switch or join during the Annual Enrollment Period (October 15 through December 7).
Find available plans in your area by using a self-enrollment tool. However, navigating through this process can be complex, and that's where our EASY Insurance Plans agents can help.
Learn About Your Coverage Options
Ready to explore your options to save money with a zero premium coverage Medicare Advantage Plan?
At EASY Insurance Plans, we have licensed agents ready to offer a FREE consultation and help you find a suitable Medicare Advantage Zero Premium plan that best fits your needs.
Why navigate the complex world of health insurance alone? Contact us today to schedule your free consultation.