Too Good to Be True — Or Too Good to Pass Up?

Save money with Medicare Advantage plansYou’ve heard it said that “if something sounds too good to be true, it probably is.”

You may have seen Medicare Advantage plans being offered with $0 monthly premiums. A $0 monthly premium — doesn’t that sound too good to be true? But is it really too good to be true? Or is it too good to pass up?

Well, $0 monthly premium Medicare Advantage plans are certainly real. In fact, the number of $0 monthly premium plans increased 6 percent in 2016.

Still, how is it that a Medicare Advantage plan can have a $0 monthly premium? And how does having a $0 monthly premium impact other costs for someone on Medicare?

Those are great questions. Let’s get you some answers.

How Do $0 Monthly Premium Medicare Advantage Plans Work?

First, a quick refresher on Medicare Advantage plans.

Medicare Advantage, also known as Medicare Part C, combines the coverage of Original Medicare (Part A and Part B) with additional coverage. Depending on the plan, Medicare Advantage could include benefits like:

  • Dental
  • Health and wellness programs
  • Hearing
  • Prescription drugs
  • Vision

Private insurance companies, like Highmark, offer Medicare Advantage plans. You are eligible for Medicare Advantage if you are enrolled in Medicare Parts A and B, reside in a service area, and do not have end-stage renal disease.

Here’s a quick run-down on how these plans work to offer you a $0 monthly premium:

  • You paid into Part A while you were working.
  • You now pay a monthly Part B premium.
  • The government uses those dollars to pay the health insurance company.
  • The health insurance company in turn manages the Medicare Advantage (Part C) plan.
  • You pay the health insurance company for your Medicare Advantage plan.
  • The health insurance company passes savings on to you in the form of $0 monthly premiums and benefits.

Graphic showing four parts of how a $0 premium medicare advantage plan works

Is a $0 Monthly Premium Medicare Advantage Plan Right for You?

Is a $0 Monthly Premium Medicare Advantage Plan Right for You?It’s important to remember that paying $0 in monthly premiums for a Medicare Advantage plan doesn’t mean that everything is totally free. You still have to pay your Medicare Part B monthly premiums, along with any annual deductible, copayments, and coinsurance for your Medicare Advantage plan.

$0 monthly premium Medicare Advantage plans vary when it comes to:

  • Cost-sharing (the amounts you pay out of your own pocket, like deductibles, copays, and coinsurance
  • Access to a high-quality network
  • Other features, such as discounts on wellness programs, products, and services

As always, there are many things to think about when deciding on the right options for you and your family. Start by asking yourself these questions:

  • How much am I comfortable paying out-of-pocket for care?
  • Am I willing to pay more in out-of-pocket costs in exchange for a lower monthly premium?
  • Is it important to have access to a broad network of providers, or am I comfortable with a narrower network of providers?
  • Do I travel a lot outside of my plan’s service area?
  • How often do I typically seek care in a given year, and what kinds of care do I seek?

Highmark Is Here to Help

A $0 monthly premium Medicare Advantage plan can be a great way for you to lower your costs for Medicare coverage. Highmark offers them as options for our Medicare Advantage members, and we’ll be happy to help you decide if one of these plans is right for you.

That goes for any of the questions you may have about Medicare coverage — Highmark is here to help. Check out these online resources to help you understand your Medicare plan options, and you can find even more ways to get help in the sidebars to this article.

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