Depending on where you live, you may be able to find a $0 Medicare Advantage plan in your area. Learn how these plans work and what other costs might you incur.
One of the first things people may want to know when shopping for health insurance coverage the cost of the plan. But what if there were affordable Medicare Advantage plans that offered $0 premiums?1
There are over 3,550 Medicare Advantage plans for sale in the U.S. in 2021, and many of those have $0 premiums.2 Here we’ll take a detailed look at these plans and help you make the most informed decision regarding your Medicare coverage.
How can a Medicare Advantage plan have a $0 premium?
Medicare Advantage plans with $0 premiums may still include some other cost requirements, similar to those that can be found with plans that do have premium costs. These costs may include:
Deductibles Medicare Part A, Part B, Part C and Part D plans can each have a deductible, which is the amount you must pay out of pocket before Medicare or your plan pays its share. Deductibles typically apply on an annual basis and reset with each new plan year. (This is not the case with Medicare Part A, however. The Part A deductible must be met during each benefit period, which starts the day you’re admitted for inpatient hospital care and ends when you stopped receiving inpatient care for 60 consecutive days.)
Copayments or coinsurance $0 premium Medicare Advantage plans may feature certain cost-sharing measures such as copayments (a flat fee) or coinsurance (a percentage of the cost of services or equipment). A copayment or coinsurance is the amount that you must pay for medical services, doctor visits, medical equipment or prescription drugs after your deductible is met.
For example, if you are enrolled in a Medicare Advantage plan with 20 percent coinsurance charges, you will pay 20 percent of the total cost of medical services you receive after you have met your plan’s deductible. Your plan will cover the remaining 80 percent of the costs.
By contrast, a $30 copay requires you to pay $30 for each service you receive after your deductible is met, regardless of the total bill amount for the covered services.
Out-of-pocket maximums A plan’s out-of-pocket maximum is the total amount you can expect to pay during a plan year. Medicare Advantage plans will pay 100 percent of the remaining costs for covered services for the remainder of the year once this maximum is reached. By law, Medicare Advantage plans had to have an out-of-pocket maximum of no more than $7,750 in 2021.
Out-of-network costs Medicare Advantage plans can be structured in a number of different ways, including Medicare HMO and Medicare PPO plan types, among others. Some of these types of Medicare Advantage plans include a network of preferred health care providers. With some of these plans, it may cost more money to receive approved medical care outside of the plan’s network. In some cases, out-of-network care may not be covered at all.
Part B premium Anyone who wants to enroll in a Medicare Advantage plan, whether it’s a $0 premium Medicare Advantage plan or not, must remain enrolled in both Part A and Part B of Medicare. Most people do not pay a premium for Part A, but the standard Part B premium for 2021 is $148.50 per month. If you are enrolled in a $0 Medicare Advantage plan, you must continue to pay your Medicare Part B premiums (and Part A premiums, if you do not receive premium-free Part A).
How many Medicare Advantage plans have $0 premiums?
Nearly 9 out every 10 Medicare Advantage plans include prescription drug coverage. These plans are called Medicare Advantage Prescription Drug plans (MA-PDs). In 2021, 96 percent of Medicare Advantage beneficiaries have access to an MA-PD that features $0 monthly premiums.1
What do $0 premium Medicare Advantage plans cover?
By law, Medicare Advantage plans must provide the same basic coverage as Part A and Part B of Medicare (though you still receive coverage for hospice care through Medicare Part A).
Like any Medicare Advantage plan, a $0 premium plan may offer different benefits than other available plans.
Read additional medicare costs guides to learn more about Medicare costs and how they will affect you.
Where can I get a $0 Medicare Advantage plan?
Every state except Alaska has Medicare Advantage plans for sale in 2021. Not every area within each state will necessarily have a $0 premium plan for sale, as costs and availability vary all across the U.S.
If you’re interested in comparing Medicare Advantage plans where you live, contact a licensed insurance agent to review available plans and to learn more about what each plan may have to offer.
Find $0 premium Medicare Advantage plans in your area
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1 You must continue to pay your Medicare Part B premium. $0 premium plans may not be available in all areas. 2 Fuglesten Biniek J., et al. (Oct. 29, 2020) Medicare Advantage 2021 Spotlight: First Look. Kaiser Family Foundation. www.kff.org/medicare/issue-brief/medicare-advantage-2021-spotlight-first-look.
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