Are Medicare Advantage plans really "free," or is that just clever marketing?
Answered by 100 licensed agents
The concept of "free" Medicare Advantage plans can be misleading. While some Medicare Advantage plans advertise $0 monthly premiums, it's crucial to understand that this doesn't mean you won't have any healthcare costs. Here's a breakdown:
* $0 Premium Doesn't Mean $0 Cost:
A $0 premium means you don't pay a monthly fee to the private insurance company offering the Medicare Advantage plan. However, you'll still likely have other out-of-pocket costs, such as:
* Co-payments: Fixed amounts you pay for specific services (e.g., doctor's visits, prescriptions).
* Coinsurance: A percentage of the cost you pay for services.
* Deductibles: The amount you pay before your plan starts covering costs.
Free is a catchy marketing word. Many have no monthly premium so in that sence, yes. If we are looking at overall cost (premiums, co-pays, deductible etc...) then no. Advantage plans will have co-payments for things like doctors office visits, tests, radiology, the emergency room and the hospital, but they are set co-payments that are usually very reasonable. Additionally, there is an out of pocket maximum, so you know your worst case senerio. Note that few people reach the out of pocket maximum, so it is not really an annual cost. In comparison, Medicare supplement G only has you pay a Deductible ($254 in 2025) for services, so many people with supplements feel that visits, tests and hospital stays are "free" but fail to account for the monthly premium they pay no matter if they use the plan or not. In comparison, Medicare Advantage will come out well ahead in years with fewer medical procedures. As good years usually well outnumber the bad, Medicare Advantage usually wins.
several carriers offer zero premium plans for medicare advantage plans. they can do this because they get paid by medicare to coordinate your medical care
Most Medicare Advantage plans offer $0 monthly premiums and $0 primary care visits. This also depends on your zip code or service area. You'll want to consider copays and benefits of each plan to ensure it is the right one that fits your individual needs. Some advantage plans may have health deductibles or prescription deductibles. You'll want to ensure whoever you are working with goes over the summary of benefits of the plan.
Some Plans have no monthly premium costs, to the members and some do depending on the plan you are applying for. For instance a PPO plan or an HMO plan. you need to talk to an agent.
The old saying is that there is no free lunch and it applies to Advantage Plans as well. In this case the cost isn't born by the person enrolled in the plan the cost is carried by tax payers. Medicare, whether traditional or Advantage, is subsidized by the Federal government. Advantage Plans cost the government approximately 22% more than traditional Medicare does.
There are several reasons for this. Commissions for agents are much higher with Advantage plans than for Medicare Supplements. Marketing expenses are greater with Advantage Plans. On top of all that the Advantage Plans have lobbied congress and rule makers enough that they get extra subsidies the sicker an enrollee is. The kicker is that they get those extra funds regardless of whether the enrollee gets more healthcare or not.
In a word, "NO" it isn't free. It's just clever marketing.
Several Medicare Advantage plans have a zero monthly premium, but you should remember that you will still need to pay your Medicare Part B premium each month in order to be eligible for a Medicare Advantage Plan such as these.
Well nothing life is "free" you already know that is not true. How ever there are plans that arr no addition cost to you. How I explain is $0 or zero dollar plans per month are no more monthly cost paid to the insurance companies than what you are already paying for Original Medicare.
Then these plans do really have cost to them in the form of Co-Pays, Co-Insurance and Max Out of Pocket. But "free" is relative and can be explain better as no additional cost to over what you are paying for Original Medicare. This can be a complicated questions and depends on a lot of factors if these kinds of plans are a good fit for you. Contact us to see if a $0 premium plan is a good fit for you!
There are $0/premium plans out there, but you must be enrolled in Part B which has a premium of $185/month unless you get assistance through the state or county per your income level. Obviously with no premium, one can expect more out of pocket expenses when seeing doctors or hospitals, generally.
I think Medicare Advantage plans can be a great option for many consumers but labeling them as "free" is definitely clever marketing.
If the Medicare Advantage plan has a $0 premium, I describe it as such and then walk through all of the benefits with the consumer so that they understand ho the plan might have cost shares they would be responsible for.
Unlike Medicare Supplement plans, most Medicare Advantage plans offer benefits that are not covered by Medicare. Namely, dental, vision, hearing, and over the counter allowances. I always ensure that when going through the benefits, we discuss all of them and the word "free" is something I do not use. In fact, Medicare prohibits a broker from using the word free.
The correct statement should be..... Most Medicare Advantage are $0 premium plans that have Co-Pays, Co-Insurances and most importantly, a Maximum Out Of Pocket In-Network.
These plans are frequently called Pay As You Go plans. You may not spend anything or you may spend the Max Out Of Pocket. No one knows what health issues will arise in the future!
Medicare Advantage plans are NOT free. Most MA plans have a zero monthly premium and some could also have give-back options towards Part B Medicare payment. When reviewing Medicare Advantage plans ALWAYS review the Summary of Benefits to truly understand how the plan is going to work for your Medical and RX needs. Medicare Advantage plans have Co-pays.
Some Medicare Advantage plans have a $0 monthly premium. Medicare Advantage plans are subsidized by the government. Legitimate advertising must be approved by Medicare.
They are not free. You have to pay copays for just about everything and sometimes have a very large out of pocket! So, if you never get sick, they might be a money saver - God forbid if you develop a major illness!
Most Medicare Advantage plans are offered as zero-premium plans, but there are a few plans that do have a monthly premium. They can not be truly considered "free" because other costs are associated, such as your Medicare Part B Premium, and you may incur possible deductibles, copays, and coinsurance when seeking medical care up to a defined max-out-of-pocket amount.
Even with that being said, there are low-cost plans called Hospital Indemnity plans that can be purchased to help combat those out-of-pocket expenses.
I tell clients that there is nothing "free" in life. When you are thinking about either a Supplement or a MAPD plan, chose the plan you are most comfortable for you. There is no wrong answer. The plan should make you feel confortable about your health cover.
First and foremost, there are Medicare advantage plans with a premium and there are medicare advantage plans without a premium. Depending on the financial circumstance, when a recipient is responsible for paying their Medicare Part B premium with social security and may not qualify for state assistance, a 0.00 plan may be option to save some money. It is however, still subject to out-of-pocket costs and in some cases higher copays.
While it may seem like clever marketing, In order to be eligible for those plans you must be enrolled in Part A and Part B. When we look at Part B, in most cases it will cost 185.00/month which must be paid in order to enroll into any Medicare health plan including the Medicare advantage option that is 0.00.
How does losing a spouse impact my Medicare plan if I was on their employer plan Most importantly, you will have to check with the employer to see if insurance is still being offered to you. If not, there are a number of options to explore. Give me a call and we will review all options keeping you insured.
Approximately 70% of Medicare Advantage Plans (MAPD) do not have a monthly premium, but all MAPD's do have costs associated with them when they are used for most medical services. These are known mostly as copays and can be quite reasonable, especially when you use In-Network services. Many MAPD's also come with additional extra benefits that are attractive to many consumers. Benefits such as Dental, Hearing, Vision, Gym coverage, etc. Its important to understand the pros & cons for MAPD's, as well as Medicare Supplements. There is not a "one size fits all" Plan out there and talking to an experienced Agent/Broker is a wise option. Plan ahead before starting Medicare and learn as much as you can.
They have zero dollar premiums on most. Being free is a matter of perspective. You will still need to understand what your costs are, ie copays, deductibles and Coinsurance. A good broker can help you field these questions at no cost as well.
Medicare Advantage plans are not free. Some plans have a premium and some have no premium. Either way they are funded by tax dollars, so you have been paying into it your whole working life.
Many Medicare Advantage plans have $0 premium. It is helpful to have a local agent who can explain the differences in the various policies and their premiums.
"Free" is not a word that should be used when referring to Medicare products. Many plans have no premium cost but have out-of-pocket expenses that a Medicare enrollee may incur.
There are costs to the Medicare Advantage plans. The Part B premium is still taken out of your SSI. There are out of pocket costs for the Deductibles with hospital stays, and prescription drugs, along with Co-Pays for hospital, prescription drugs or out of network providers.
While many Medicare Advantage plans have "Zero Premium", they are not "free" in that they do come with certain copays and out of pocket expenses that require some costs in most cases. While for many, they are the best way to go for coverage and protection, I like to always educate my clients on all options that could best be of benefit for their unique circumstances and needs.
While some Medicare Advantage plans advertise zero monthly premiums, they aren't truly "free." You'll still need to pay your Medicare Part B premium and may incur costs like deductibles, coinsurance, and copayments for medical services.
You've heard that "there's no such thing as a free lunch." Well, the same is true of Medicare Advantage plans.
While it's true that there are Medicare Advantage plans that cost $0 in premium, they are not 'free' for a variety of reasons:
1. In order to qualify for a Medicare Advantage plan, you must have both Medicare Part A and Medicare Part B. There is a premium for Part B that must be paid every month.
2. You accept the terms and conditions of the Medicare Advantage plan that you choose, and that includes copayments and an out-of-pocket maximum for the services you receive. The fees you pay could add-up to thousands of dollars each year. While Medicare Advantage plans must be at least as good as Original Medicare, there will certainly be a cost to receiving medical care under Medicare Advantage.
3. Your Medicare Advantage plan is being paid by Medicare. Because they have taken-over responsibility for your medical needs, Medicare pays them a portion of what they expected to pay for your claims. The Medicare Advantage plan then decides how to spend that money in benefits. As the Medicare budget changes every year, so does the Medicare Advantage plan. It is important to review the changes in your Medicare Advantage plan every year.
4. You may end-up benefiting from Medicare Advantage by paying a little more for your medical claims, while receiving "extra" benefits like dental, vision, hearing, fitness, prescription drug and over-the-counter drug benefits at little to no cost. But in a year where you have a lot of expensive medical treatment, you could pay a lot more out of your pocket.
No Advantage plans are definitely not free, even though some with Seniors do not have to pay a monthly premium. Most of the services require either copayments or co-insurance % payments, or both. Some preventive services are low or no cost, but most have some cost to them. Still, they are a great value, especially if seniors are in pretty good health!
There are plans that are Zero Premium ($0). So yes, you can get a zero monthly premium plan.
The clever marketing comes into play when I hear the commercial saying, " If you have Medicare you are entitled to received $4300 back...." etc. Always have a local agent who is looking out for you.
They are not "free" plans, these plans are a pay-as-you-go plan. They do offer benefits that original Medicare does not offer, such as coverage for Dental, Vision, and hearing.
Most Medicare Advantage Plans have no monthly premiums however there are deductibles, co-pays and co-insurance so it is important to understand that with Medicare Advantage Plans there will be some out of pocket or share of cost. Medicare Advantage Plans are Network plans so if the policyholder stays in Network their is minimal out of pocket.
Medicare Advantage plans may sound "free", but they are not really free. You will still need to pay for co-pays and/or your Medicare Part B. It just means there is no extra cost to join the plan.
Nothing is free. Medicare Advantage plans do offer plans with a zero monthly premium, but there are other costs associated with those plans. I strongly advise you to find a local agent you can trust that can explain these plans, in detail, before enrolling in one.
They are not free. They do have clever marketing and lots of people believe it. Most of them don’t realize that they are giving up real Medicare for an HMO.
Most Medicare Advantage plans, not all, are free. Zero monthly premium and there is no catch to that. These private plans get paid by the government to take you on as a client. They come with extra benefits that the original Medicare does not have. With the Advantage plans you agree to use the providers who are in network as oppose to the original Medicare which is accepted by a larger number of providers.
Medicare Advantage plans come with a $0 monthly premium. It does require co-pays for some services. Depending on the level of assistance, some clients may qualify for a plan with $0 monthly premium and $0 co-pays, but that is determined by the level of assistance the client is qualified for.
Medicare Advantage plans may have a zero premium each month, but they will also have a annual "out of pocket" maximum. This amount may be significant and certainly may be equal or greater than the premiums that you might have paid for a Medicare Supplement with Original Medicare. It's important to review the pros/cons of both and to choose the plan that best meets your individual needs.
The legal term is " Zero Cost". While Medicare Advantage plans have no monthly cost in most cases, that doesn't mean it won't cost. Think of Medicare Advantage plans as " pay as you go" plans. Copays for daily hospital stays, specialist visits, x-rays, MRI, cat scans , etc can add up. Pay close attention to the carrier's MOOP. MOOP means maximum out of pocket. In some cases it is a better financial decision to pay $1400-1600 per year for a Medicare Supplement than pay $3500+ for a Medicare Advantage plan. Make sure you have an agent that can share the advantages/ disadvantages to each choice.
Medicare Advantage plans are paid from our deposits into Medicare during our working years. So, to be clear, all Medicare Advantage companies are paid from our money.
Each carrier may change its plans every year to attract and reduce the number of clients it has in the different plans. Some plans leave the marketplace, and insurance companies create new ones.
In order to attract clients, Medicare Advantage companies include dental, hearing, vision, and over-the-counter benefits, but some even back money toward the Medicare Part B premium (tax) that the policyholder pays every month.
Many Medicare Advantage plans do not have a monthly premium. However, you share in the costs in the form of copays or coinsurance. This is how you are able to have no or a low monthly premium.
Most Advantage plans really do cost $0 each month (this is additional monthly - remember that pesky $185 part B premium will still come out of your social security check each month), which is a lifesaver if a hefty monthly premium just isn’t in the budget due to your part B premium. Yes, you’ll have co‑pays when you visit the doctor or fill a prescription, but here’s the big win: every plan puts a hard ceiling on what you’ll spend in a year.
With Original or Traditional Medicare (part A and B only) you’re on the hook for 20 % of every bill—whether it’s a $100 X‑ray ($20 out of pocket) or a $100,000 surgery ($20,000 out of pocket!). An Advantage plan might cap your yearly costs at, say, $4,500 or $6,700. Once you hit that limit, the plan pays 100 % of covered services. For many folks, that cap is the difference between a manageable expense and a second mortgage.
Each plan sets its own max‑out‑of‑pocket and co‑pay schedule, so talking with a licensed, independent broker (that’s me!) is the best way to see the full landscape and pick the plan that saves you the most. If high monthly premiums aren’t an option—or you just like keeping more money in your pocket—let’s chat. Reach out today and we’ll find the Advantage plan that fits your health needs and your wallet.
Not so much as "Free". In fact we're encourged to not use the word "free" in our presentations about health plans offered by carriers. There are plans available that are of "no cost" to consumers and then there are others with limited cost. It all depends on what an indiviual would qualify for.
Medicare Advantage plans are not free! They are zero dollar cost up front, but there are co payments and co-insurance associated with these plans. It is a clever marketing ploy.
Free' sounds great—but nothing in healthcare is ever truly free. Many Medicare Advantage plans have $0 premiums, but you pay in other ways. Co-pays, prior authorizations, network restrictions, and expensive bills to pay if you go out of network.
The #1 reason some people steer clear? Loss of control. With Medicare Supplements, you can see almost any doctor or specialist in the country without referrals. Advantage plans have networks that need approvals to access certain treatments.
With my clients, about 30%, the trade-offs are worth it. For others, they’re deal-breakers. With MedWiseTrust, it’s not about ‘free’—it’s about what 'fits' you. I’m here as your partner to figure that out.
Medicare Advantage (MA) plans are not entirely "free." While some MA plans have $0 premiums, they often come with other costs and limitations.
What to Consider
Premiums: You'll still pay your Medicare Part B premium.
Out-of-Pocket Costs: Copays, coinsurance, and deductibles apply.
Network Restrictions: Seeing out-of-network providers may result in higher costs.
Maximum Out-of-Pocket (MOOP): You'll pay up to a certain limit annually.
Before Enrolling
Research: Compare plans and review the fine print.
Ask Questions: Clarify doubts with the plan provider or a licensed insurance agent.
Confused About Medicare Advantage Plans?
Don't worry, I'm here to help. With so many plans available, it can be overwhelming to choose the right one.
Call me directly at 407-244-6951 for a personalized consultation. I'll help you navigate the complex world of Medicare Advantage plans and find the best fit for your healthcare needs.
Many Medicare Advantage plans have a zero dollar monthly premium, and then some have small monthly premiums. However, they are not totally free. They do have copays and coinsurance when you use the plans but also protect the client with an annual maximum out of pocket.
Medicare Advantage plans cannot be touted as "free". They can be zero-premium plans that cost nothing consistently per month, even if you have to continue paying for your Medicare Part B. Unless Medicaid is involved at a certain level, you will more than likely have copays and other costs.
No, Medicare Advantage Plans are not free. You may have a zero premium plan, but copays and coinsurance are your responsibility. Your Part b Premium has to be paid to keep the coverage.
The idea that Medicare Advantage plans are “free” is generally more of a marketing strategy than a literal truth. While many Medicare Advantage plans have low or even $0 premiums, this doesn’t mean they are free in the overall sense.
Out-of-Pocket Costs: Even if the premium is $0, there are still costs like co-pays, deductibles, and co-insurance for doctor visits, hospital stays, prescription drugs, and other services. The out-of-pocket costs can add up, depending on the plan and the services you use.
Network Limitations: Many Medicare Advantage plans are HMO or PPO plans, meaning they have network restrictions. You might have to stay within a network of doctors and hospitals, and if you go outside that network, you'll pay more or your care may not be covered at all.
Medicare Advantage plans, frequently advertised as "no-cost" options, can mislead consumers in how they are portrayed. These plans may not impose a premium in addition to the mandatory payment for Medicare Part B, but they do not qualify as completely free. Consider these central points: A premium is still a part of the monthly costs for many Medicare Advantage enrollees; it just may not be called a premium.
1. Premiums and Cost Sharing
A number of Medicare Advantage plans require participants to pay premiums. While some of these plans have no premiums, even they require the beneficiaries to pay their Part B premium. Moreover, in any given plan, that is not the whole story financially. This section also examines what else the plans require beneficiaries to pay. Often, that comes down to cost-sharing. In plans that do have it, costs can take various forms including: copayments, coinsurance, and deductibles.
2. Network Limitations
Most Medicare Advantage plans run a network of doctors and hospitals. If you need care from outside that network, you could face steep bills—if you're covered at all. This possible outcome is a big reason to carefully read Medicare Advantage plan materials before enrolling.
3. Coverage Variability
Medicare Advantage plans can offer a range of different benefits. Some plans toss in fluffy stuff like dental and vision care, wellness programs, and the like. But don’t be fooled! Plans that do so may have you pay more or may simply be restricting access more than you realize. Read the fine print.
4. Marketing Strategies
"Free" is often a term used in marketing to draw in beneficiaries. As with any kind of bait, it should be examined with a critical eye. Just because there is no premium, one must remember to look at the total associated costs of the plan before jumping on the "free" bandwagon.
To sum up, although certain facets of Medicare Advantage plans may save money, they are not genuinely without cost.
There is nothing clever in being misleading. As a broker I am contracted with many carriers. I don’t sway toward supplements or Medicare Advantage. It is really an individual assessment. There are MA’s with no monthly premium, but as with all Advantage plans you carry the copays of services that a supplement might take care of. It is a matter of where you want to budget your health care.
There’s always a cost some where. When you have Medicare A and enroll in Part B (that cost), that allows you to have a Medicare advantage plan. Then Medicare pays the health insurance company to manage your health care for you. The advantage plans are created for folks who can’t afford the high monthly payment of a supplement.
Some Medicare Advantage plans have a $0 monthly premium. This means you don't pay a regular monthly fee just to be in the plan. You almost always have to still pay your Medicare Part B monthly premium.
No, Medicare Advantage plans are generally not free. While some plans may offer a $0 monthly premium, there will still be other out-of-pocket costs such as deductibles, copayments, and coinsurance.
The average monthly premium for a Medicare Advantage plan is around $17, but this can vary depending on the plan. Additionally, you will still need to pay your Part B premium, which is currently $185 per month.
It's important to compare the costs and benefits of different Medicare Advantage plans before making a decision. Some plans may have higher premiums but offer more coverage, while others may have lower premiums but more out-of-pocket costs
There are Medicare Advantage plans that are at no cost to the client when we are speaking about monthly premium. However, there are many companies and agents out there that leave out important information about plan costs, deductibles, what it takes to qualify, as well as many other factors.
Medicare Advantage plans are not "free". They are subsidized by your Medicare premiums. When you choose a Medicare Advantage plan option, the federal government is no longer paying your healthcare costs, so they provide a portion of your Medicare premiums to the plan that you have chosen so that they can manage your benefits and claims payments.
Most of them are free, in addition to your Medicare Part B premium that you are ready paying and most of them offer many more benefits that original Medicare doesn't cover.
It depends on the financial needs of the applicant. It isn't free in the sense that taxpayers pay into a fund throughout their workable (or "accumulating years"), which then pays to help maintain and manage our aging population's health needs when they are older. However, there are some plans that have $0 premiums.
Some applicants who receive state benefits or have a qualifying condition may qualify for financial assistance with Medicare Advantage plans. However, there are other costs, such as out-of-pocket costs, Part B premiums paid directly to the government, and other shared costs that have to be considered as well.
Medicare Advantage plans aren’t exactly 'free'—that’s clever marketing. While many have a $0 monthly premium, you still pay your Medicare Part B premium and may have copays, deductibles, or other out-of-pocket costs. The key is knowing what you're actually getting and making sure the plan fits your needs.
I wouldn't say free, some Medicare Advantage plans do have a premium, however, most are at $0 premium per month. When enrolling in a MA/MAPD you are agreeing to a more traditional cost sharing model with possible deductibles, copays, coinsurance, and a max out of pocket. Medicare Advantage works for a lot of senior. As long as you assure your doctors are in network and your medications are covered at a rate you feel works for you, it can be a great way to save precious dollars.
Majority of the plans are no cost to you. Some plans may have a premium but many will not. Always make sure that question is answered before you enroll in a plan.
Most Medicare Advantage plans are $0 monthly premium. There are advantages and disadvantages to every plan, it is important to make a knowledgeable decision your first year in Medicare.
Some Medicare advantage plan have no premiums, but you have to have Medicare A and B. For most people Medicare part B has a monthly premium. However, some plans do give you a monthly discount on Medicare part B.
We agents never use the word "free" when working with clients that is very misleading. All plans do have a cost involved and should be reviewed with each client that an agent works with to make sure they understand.
Free is not a term we are allowed to use to describe Medicare Advantage plans, but, yes, there are a number of $0 premium plans out there that may fit your needs. Plan choices vary by the county you live in.
Free is probably not the most accurate description. Each Medicare eligible person needs to have Medicare A and B (which has a cost for most people) to qualify for a Medicare Advantage plan. The plans often don't have an up front monthly premium, but somewhat like health insurance there is out of pocket expense for medical and prescription costs. That being the case, it's important to carefully review plans to be sure the out of pocket costs are acceptable in each person's situation.
Nothing worthwhile is free and that certainly goes for your insurance. In the world of Medicare, $0 premium does NOT mean free. There are going to be costs for services received while on a Medicare Advantage plan. However, the $0 premium does mean you will only pay for services when you need them, as you need them, and not automatically every month.
As a general rule, if it's marketing, proceed with caution! An independent agent can help you see through the "noise" of marketing and get to the real info that matters.
While some Medicare Advantage plans have a $0 monthly premium, they are not truly "free." You will still be responsible for other healthcare costs, including your Part B premium, deductibles, copayments, and coinsurance. It's crucial to look beyond the premium and carefully consider the plan's overall costs, benefits, network, and rules before making a decision.
To call Medicare Advantage plans "free" is over simplifying. Many (but not all) Medicare Advantage plans have $0 monthly premiums so if premiums were the only important consideration, they could be considered "free". But there are many other factors to consider, such as deductibles, copays, drug coverage, etc. A Medicare Advantage plan can be an excellent value when paired well with clients priorities but its critical to look at all aspects of the plan such as whether all of your doctors are in network, all of your medications are covered by the plan, and many other considerations. As your Medicare Broker, it is my job to not only recommend a plan tailored to your needs but also to make your health coverage easier to understand.
"Free" is not a term us agents and brokers should use. Nothing is really free. The cost per month for most Medicare Advantage plans is $0. Some Medicare Advantage plans have a cost associated with them. It's important to know that the Medicare client still needs to maintain Medicare Parts A and B in order to keep their Medicare Advantage plan. Once a client is enrolled in a Medicare Advantage plan, there are "copays" for everything. Copays for doctor visits, copays for hospital stay, copays for surgery, etc. Each plan is different and these copays vary based on the plan. As a Medicare broker, I can help you understand the details and costs associated with your Medicare Advantage coverage.
Everyone on Medicare Part B must pay the Part B premium to CMS which currently is $185/month.
There may be a no cost monthly premium for most Medicare Advantage plans. However, there are other costs that may apply like copays, coinsurance and Maximum Out of Pocket costs for medical services. Medicare Advantage plans have pros and cons as does Original Medicare with Medigap Supplement plans.
The best suggestion is to talk to a Medicare professional who can fully educate you on the true costs and benefits of MA plans vs. Medigap Supplemental plans. This is a critical decision and seniors need to be completely educated on Medicare to avoid expensive mistakes down the road.
Many Medicare advantage plans are free, some are not. Everyone must pay the Medicare part B premium however, this is unavoidable unless you qualify for extra help or Medicaid.
Some Medicare Advantage plans have a “zero” monthly premium. Plans vary in features and premiums and one size does not fit all. It is helpful to do a side-by-side comparison to see the difference in each plan.
CMS, (The Center for Medicare and Medicaid Services) does not allow the use of the word "FREE". There may be plans that are low cost or NO COST to you (the consumer) yet the plans are definitely not free. Clients frequently ask how this is possible? Medicare Advantage Organizations (carriers with a CMS contract) are paid by the federal government for each member they have enrolled. Contract levels vary depending on the specific county location, average cost of services, and the quality of the service provided (star levels) by that carrier. It becomes the responsibility of the MA provider to manage those dollars. They must provide a level of service equal to, or better than, the coverage offered through original Medicare. Some plans may offer certain rebates (food cards, gym memberships, Part B premiums, etc.) to entice more enrollments. They may also provide additional services like Dental, Vision, or Hearing, that are not covered under original Medicare.
Medicare Advantage plans have a $0 premium cost to clients as they received funds from the Federal Government when you enroll in a Medicare Advantage plan. The Government provides these funds to the insurance company in return for the Insurance company taking over the full administration of your Medicare A&B benefits.
Some Medicare Advantage plans have a $0 monthly premium, this does not mean they are entirely free. Beneficiaries still must pay their Medicare Part B premium (which is typically deducted from Social Security benefits) regardless of whether they choose a Medicare Advantage plan.
Medicare Advantage plans are often marketed as "free," but this can be misleading. Here's a breakdown to clarify:
1. **Monthly Premiums**: While some Medicare Advantage plans have low or even $0 monthly premiums, you may still be responsible for other costs, such as copayments, deductibles, and coinsurance.
2. **Medicare Part B Premium**: Even if the Advantage plan itself is free, you still need to pay your Medicare Part B premium, which is typically deducted from your Social Security benefits.
3. **Out-of-Pocket Costs**: Many plans have out-of-pocket expenses that can add up, especially if you require frequent medical care or services.
4. **Network Restrictions**: Many Advantage plans have specific networks of providers, and going out of network can result in higher costs or no coverage at all.
5. **Limitations on Coverage**: While these plans often include additional benefits (like dental or vision), they may not cover everything that traditional Medicare does, which can lead to unexpected costs.
So, while some aspects of Medicare Advantage plans can appear "free," it's essential to carefully review the details and understand all potential costs involved before enrolling. It’s always a good idea to compare plans and consider your healthcare needs.
The confusion that people run into is the process. Remember, you have paid for Medicare Part A through employment deductions you working life and you then pay for Medicare Part B as you start to enjoy Medicare coverage. That money is given to Insurance Carriers to then find a way to manage care in a way that they can be profitable. It is a different experience from Medicare Supplement - but based on choosing a plan that meets your needs can be exactly what you need.
There are many Medicare Advantage plans that have a zero dollar monthly premium that include extra benefits such as dental, vision, and hearing at no additional cost. It is always best to learn all the options available to you every annual election period. You may even qualify for a special enrollment period during the year.
Some have a zero cost for the premium each month for the actual policy. However, the services you use like doctors visits, specialist's and outpatient visits are not free. There is a co-pay. If you get sick and have go into the hospital, some advantage plans only cover a certain amount of days.
The plans that are $0 premium are subsidized by the Federal Government to the carrier. The carrier in exchange provides a benefit level equal to and better than what the regular Medicare program can provide. There are copays associated with the plans but they are either free or have a low cost to the public. They can be a significant help to low income seniors and seniors that need additional benefits. Every Medicare beneficiary has a unique risk profile so meeting with an agent to discuss will help you decide what is best for the beneficiary.
Most Medicare Advantage Plans do have a zero premium, however beneficiaries pay copays for the majority of services up to $10,000 annually, so NO they are not free. Costs for hospitalization are steep, imaging and other major services carry hefty copays.
While you might find plans with a $0 monthly premium, this comes with important context and conditions:
You still need to be enrolled in Medicare Part A and Part B: These are not free. You've paid into Part A through payroll taxes during your working years, and you continue to pay the standard Part B premium (or potentially more depending on your income).
The $0 premium often applies to specific types of plans, like HMOs: These plans typically require you to stay within a network of doctors and hospitals to receive coverage. Going out-of-network may result in higher costs or no coverage at all.
It's more accurate to say that these plans can offer a way to receive your Medicare benefits through a private insurance company, often with extra benefits, after you've already met the requirements of Medicare (and continue to pay your Part B premium).
They are never free. Many plans are zero premium but they all have co-pays and co-insurance for certain services. They do, however, all have a annual max out of pocket to limit annual costs for the subscriber. The key point to know is that you are assigning your Original Medicare benefits to a private Insurance carrier...Humana, UHC, etc. The reason they are zero premium is because Medicare pays them a monthly fee to manage your health care. There are cases where this type of plan may not be a good fit.
Medicare Advantage plans often have $0 premiums, but they’re not truly “free”—you still have to pay your Part B premium and may have out-of-pocket costs for services. It’s important to look beyond the marketing and understand the plan’s copays, deductibles, and network limitations.