Are Medicare Advantage plans really "free," or is that just clever marketing?
Answered by 249 licensed agents
* $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.
Answered by Pete Alberti on March 27, 2025
Broker Licensed in KY, FL, IN & 8 other states
Answered by Gary Church on June 3, 2025
Broker Licensed in Ca, AZ, NV & TX
Hi, thanks for watching. So the question is, are Medicare Advantage plans really free or is that just clever marketing? Well, when they say free, many, I'll say here in the Phoenix area, most of the Medicare Advantage plans don't have a premium. It's a zero premium. But it's a copay-based system, meaning when you go get services, it's all based on copay. If you go into the hospital, it's going to be a certain dollar amount for the first five or six days. If you go see a specialist, it's going to be a certain amount. If you have an ambulance, it's a certain amount. That's why people say that it's free. You don't pay monthly for it, but you pay based on the services that you're getting at the time. If you get a Medicare Supplement plan, sometimes called a Medigap plan, you're paying upfront for the monthly premium for what you might use in the future. Typically, you don't have any copays or any payments when you get services, but you're paying for that Medigap plan each month plus a drug plan. So it's just a matter of do you want to pay upfront or do you want a copay-based system and kind of a pay-as-you-go way.
Answered by Steve and Sue Brauer on August 27, 2025
Broker Licensed in AZ & CA
Carriers get from 800 to 3000 per month for each person who elects an Advantage plan, and Medicare is not responsible for you treatment, the carrier is
Answered by Mike Alexander on October 20, 2025
Broker Licensed in TX, AL, AR & 16 other states
Answered by Mark Bilgere on October 20, 2025
Broker Licensed in TX, AR, IN & LA, MN, NE & OK
So do want to give up your freedom and control of your health? Do you care if you travel - even out of county - that you may be in a Non-Network, no coverage zone? Do you want to give someone else the authority to decide if you will have a needed surgery or not? Is that grocery card worth it?
They have you focused on 1 thing that is less important, than where the real focus should be. It’s like a magician!!! So don’t be tricked!
Answered by Norman Smith on September 30, 2025
Agent Licensed in FL, AL, NJ & PA
Answered by Lt Col Tim Brown on June 27, 2025
Broker Licensed in TN, AL, CO & 10 other states
It is true that Medicare Advantage plans have a low or no monthly premium. However, keep in mind that everyone who is in a Medicare Advantage plan or a Medicare supplement, a Medigap plan, must be enrolled in Part A and Part B. Now, the Part B premium in 2025 is $185 a month. So, it's not free for Part B. The reason that Medicare Advantage plans can be offered at such low premiums or no premium at all is that $185 a month goes to the insurance companies. You multiply that $185 by tens of thousands of people, and that's how they can afford a very low or no monthly premium.
Answered by William Lawler on April 9, 2025
Broker Licensed in MO, FL, IA & 12 other states
A compliant insurance agent/broker is forbidden from using the words "free" or "this is the best plan for you". If someone is Dual Eligible (Full Dual Eligible Medicaid and Medicare) and they see providers who accept both Medicare and Medicaid, they should have 100% no-copays or financial responsibility for their medical expenses. This does not apply to all medications, there can still be a partial co-pay for name-brand drugs for Dual Eligible Medicare/Medicaid beneficiaries.
Unfortunately, many brokers, especially call centers will not review the Summary of Benefits with the person explaining applicable co-pays (for Non Dual Eligible enrollees) such as emergency room, specialist appointments, inpatient hospital admissions, chemotherapy, durable medical equipment, etc. Many insurance carriers offer some Medicare Advantage Plans with Over The Counter (OTC) benefits and gym memberships at no cost to the enrollee. Some plans also offer partial, limited coverage for glasses and dental as well (as applicable). These benefits are listed in your Summary of Benefits (as applicable).
The bottom line, if someone has no eligibility for any Federal, State, Tribal, local, or hospital financial assistance programs, they should be 100% accountable for any applicable co-pays in their Summary of Benefits or Evidence of Coverage- printed guidelines. These guidelines may change from year to year. Check with your Medicare Advantage Plan Carrier website to review your current Summary of Benefits or Evidence of Coverage to verify your current plan.
Answered by Christopher Boyd on August 27, 2025
Agent Licensed in IN, KY, MI, OH, PA & TN
They are clever marketing and nothing else!
If you need good coverage, just pay a small premium and get a Medicare supplement plan!
For more information, contact George Ibanez.
Answered by George Ibanez on October 1, 2025
Broker Licensed in AR, AL, AZ & 40 other states
Answered by Voss Speros on April 13, 2026
Broker Licensed in AZ, CA, CO & 19 other states
Answered by Pamela Masters on September 26, 2025
Broker Licensed in NC
Medicare agents have lots of questions, and we've got the answers. Are Medicare Advantage plans really free, or is that just clever marketing? I don't know that I've seen that they're free. I hear them touting from the rooftops and on TV 24/7 that they have zero premiums per month, but that doesn't mean they're free. Medicare Advantage plans have copays and out-of-pocket costs.
Every one of them here in the state of New Hampshire, where my State Farm agency is located on Kelly Street in Manchester, has an out-of-pocket cost maximum. Most of them are anywhere from $5,000 to $9,500, so they are not free. Again, you may be mesmerized when they have all the ads and all the mailbox stuffing that show zero premiums per month. But remember, copays and out-of-pocket costs add up quickly.
Work with someone like myself who can offer not only Medicare Advantage plans but also Medicare supplement plans. I have no preconceived notions of what you need to buy. I go based on your goals and objectives. I will explain Medicare Advantage, and I will explain Medicare supplement so that you know it inside and out and won't make any decisions based on incorrect information.
We will give you great information so that you can make a good decision. Please allow me to do that or any of the folks, whatever state you're in.
Answered by Tony Capraro III on November 11, 2025
Agent Licensed in NH & ME
Answered by Ray McCauley on March 27, 2025
Broker Licensed in CA, AZ, FL & ID, NV, SC & TN
Answered by Christy Jones on September 6, 2025
Broker Licensed in ID, AL, AR & 20 other states
Okay, the question is, are Medicare Advantage plans really free or is that just clever marketing? Well, no one ever said the Advantage plans are free. I don't think the agent has ever said that. We're not allowed to say that. Medicare Advantage plans, many of them, have a zero plan premium. That's not free, it's a zero plan premium. You still have to have Part A and Part B Medicare in order to qualify for Medicare Advantage. You have to be a U.S. citizen with A and B Medicare, and you have to reside in a plan service area in order to get the Advantage plan you're looking at. Some of them have zero premium.
Now, the federal government, Medicare, is paying these plans approximately $1,000 a month for every month that you might have a membership in an Advantage plan. So there's money changing hands, and the government does this so they don't have to take care of you. The plan has to take care of you, and they are under very careful and close supervision by CMS, the Centers for Medicare Services. They have to obey the rules and do things right. They're getting paid to take care of you in exchange for you not having a premium. You are responsible as an Advantage plan member for certain copayments or coinsurance, depending on what happens, subject to a plan's maximum out-of-pocket. So, by law, Medicare Advantage must be better than Original Medicare, and it is.
Answered by Clarence "Mark" Christiansen on April 21, 2025
Agent Licensed in WI, AZ, CA & 16 other states
Your Part B premium (to Medicare)
Copays/coinsurance when you use services
Potential out-of-pocket costs throughout the year
In exchange, these plans often include extras like dental, vision, and prescriptions.
They can be low-cost upfront, but you pay as you use care—so it’s important to look at the total cost or max out of pocket, not just the $0 premium.
Answered by Lauren Fodde on March 30, 2026
Broker Licensed in MO & FL
Medicare advantages you pay a copay as you use it.
Many of them come with dental, vision, hearing, over the counter items, and some healthy foods!!
Answered by Tasha Riggs on March 27, 2025
Broker Licensed in CO, AZ, HI & 10 other states
Answered by Nick Mangini on October 11, 2025
Broker Licensed in FL, AL, AZ & 32 other states
Answered by Kelsey Hentzen on March 28, 2025
Broker Licensed in KS & MO
Answered by Don Hudson on August 25, 2025
Broker Licensed in FL
Answered by Darlene Murphy on June 9, 2025
Broker Licensed in CA, AZ, ID & 7 other states
Answered by Robert Pennington on March 4, 2026
Broker Licensed in NC, GA, SC & VA
Answered by David Wiley on November 17, 2025
Broker Licensed in GA & NC
One of the questions is, "Are Medicare Advantage plans really free?" Technically, no, because the Part B premium that you pay once a month comes out of your Social Security, or if you pay quarterly, it goes right over to the Medicare Advantage plan. Basically, you're subsidizing your own plan. Years ago, Medicare Advantage plans all had monthly premiums, but right now there's such a big market for them, and they're all competing against each other. Most of these plans have zero premium a month, where you don't pay a monthly premium. If you're looking at a Medicare Advantage plan, that's one of the plans I would consider.
However, you do also have a lot of copays. If you see a specialist, it's usually on average about $30, depending on the plan. For inpatient hospital stays, you're looking at around $250 each day for days one through seven, and again, that varies per plan. Your outpatient procedures are usually $400, MRIs are $200 to $400, an ambulance ride is $250, and the emergency room is about $100. So, you are paying into the plan as you use it. If you remain healthy for the rest of your life, well, guess what? You will win because you will not incur all those out-of-pocket costs.
These are the differences I explain between original Medicare and a Medigap plan compared to having a Medicare Advantage plan. Hopefully, when I explain the differences, you can choose what's best for you. I hope that helps, and if you have any other questions, just reach out to me. Have a great day! Take care.
Answered by Joseph Bachmeier on April 9, 2025
Agent Licensed in PA, AZ, DE & 5 other states
Answered by Patricia 'Tif" Bush on September 15, 2025
Broker Licensed in ct, FL, NC & SC
Answered by Robert Lukasik on September 18, 2025
Broker Licensed in NY, FL & PA
Answered by Mike Odle on March 30, 2026
Broker Licensed in IN & IL
Answered by David Bell on April 15, 2025
Agent Licensed in ID, AZ, CA & 8 other states
Answered by Sandy Johnson on January 19, 2026
Broker Licensed in LA, AL, AR & 11 other states
Answered by Adam Ashby on April 9, 2025
Broker Licensed in CO, GA, IL & 6 other states
Answered by Kate Spilsbury on October 20, 2025
Broker Licensed in FL, AZ, CA & 7 other states
Medicare Advantage Plans can be "free" as far as the premium but you may be subject to copays for certain procedures.
Answered by Paula Duffy on April 22, 2025
Agent Licensed in PA, FL, OH & WV
You will have co pays, some deductibles now, a max yearly out of pocket, prior authorizations and benefits that are shifted, adjusted and cut every year.
Answered by Christopher Palazzini on August 17, 2025
Broker Licensed in FL, CA, CO & 7 other states
Answered by Brenda Trejos on March 26, 2025
Broker Licensed in CA, AR, AZ & 28 other states
Answered by Dustin Haffner on January 7, 2026
Broker Licensed in OK, AR, KS & MO
There are some plans called Dual Special Needs plans that may be free for some people who qualify for the plan. These plans often have no monthly premium amount and the services covered by the plan are at $0 co-pay. However, you must qualify for these plans by applying for and receiving Medicaid assistance from your State. To qualify you must meet the income and asset standards set by your State.
Answered by Rose Cahill on February 9, 2026
Broker Licensed in MA
Answered by Marie Terhune on April 9, 2025
Broker Licensed in NH
Answered by Robert Vaughan, R.Ph., MBA on May 5, 2025
Broker Licensed in CA, AZ, ID, NM, NV & TX
Answered by Maureen Gildea on December 8, 2025
Broker Licensed in ME, FL & MA
Answered by David Moscowitz on March 29, 2025
Agent Licensed in NY & FL
Answered by Angie Templin on May 5, 2025
Broker Licensed in TX
Answered by Elliott Klepner on October 25, 2025
Broker Licensed in FL
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.
Answered by Andrew Bennett on April 2, 2025
Broker Licensed in TN, GA & VA
Answered by Tammera Marrs on May 1, 2025
Broker Licensed in KS
Answered by David Treadway on April 8, 2025
Broker Licensed in OH, FL, IN & KY, MI, SC & VA
Answered by Justin Lucas on May 8, 2025
Broker Licensed in IN, FL, IA & 11 other states
Answered by Kathryn Zekas on May 7, 2025
Broker Licensed in FL
Answered by Patrick Hecht on May 19, 2025
Broker Licensed in VA, CA, MD, PA & WV
Answered by Michele Vina on May 27, 2025
Broker Licensed in TX, KY, OH & OK
Answered by Tyler Dalton on May 3, 2025
Broker Licensed in AL, FL, GA & 7 other states
Answered by Holly Douglas on October 6, 2025
Broker Licensed in TN & KY
Answered by LaTosha Turknett on June 3, 2026
Broker Licensed in TX, FL, LA, NV, NY & OK
Answered by Angela Schubkegel on December 29, 2025
Broker Licensed in WI, IA, NE & SD
The answer depends on a person's definition of "free."
Many Medicare Advantage companies offer programs with zero premiums, which might be considered as "free." However, there are other costs associated with Medicare Advantage plans that can make them the most expensive plan a person can have.
My responsibility as a Medicare Specialist is to provide my clients with the information needed to make an educated decision in choosing their Medicare program. In my opinion, "free" Medicare Advantage plans can have the highest cost.
Most Medicare Advantage plans have deductibles, co-pays, coinsurance, and annual out-of-pocket maximums as high as $10,000 in 2026, which means people requiring lots of medical care can find "free" Medicare Advantage plans quite costly.
Another thing to consider is each Medicare Advantage HMO and PPO plan has a limited provider network in their coverage area. As a Medicare Specialist, I have witnessed many Medicare Advantage members suffer because they were denied access to a medical specialist not part of their Medicare Advantage plan's network.
Are Medicare Advantage plans really "free?" The premium might be $0, but the out-of-pocket expenses can cost a member thousands of dollars, plus the stress of not having access to specialized care when it's needed the most.
Answered by Doug Dent on April 14, 2026
Broker Licensed in NM, AZ, CA & 11 other states
Answered by Daniel Weeks on March 31, 2025
Broker Licensed in MN & WI
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!
Answered by James Romeo on April 9, 2025
Broker Licensed in MN
Answered by Michelle Simonds on May 5, 2025
Agent Licensed in PA, FL & NY
Answered by Peter Joseph on May 26, 2025
Broker Licensed in CA, AL, AR & 36 other states
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.
Answered by Steve Wilson on April 9, 2025
Broker Licensed in MN, AZ, FL & WI
Answered by Peter Young on April 9, 2025
Broker Licensed in MA, CT, FL & TX
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!
Answered by Jim Schueth on March 25, 2025
Broker Licensed in NE, AZ, CO & 8 other states
Answered by Terrie Boteler on March 28, 2025
Broker Licensed in MD, DC, DE, FL, VA & WV
Answered by Candace McWilliams on March 31, 2025
Agent Licensed in IN
Answered by Dianna Howell on May 19, 2025
Agent Licensed in OK
Answered by Michelle Schaefer on March 25, 2025
Broker Licensed in OK & TX
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.
Answered by Diana Garner on April 8, 2025
Broker Licensed in KY, FL, IN, OH & TN
Answered by Steve Houchens on September 25, 2025
Agent Licensed in KY & TN
Answered by Jim Tretola on October 26, 2025
Broker Licensed in NJ, CA, CT & 6 other states
Answered by Kristen Skinner on October 7, 2025
Broker Licensed in OK
Answered by Ron Cronwell on August 27, 2025
Agent Licensed in TN
Answered by Michael Pyers on March 26, 2025
Broker Licensed in OH & MI
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.
Answered by Barbara Barnes, CMIP® on April 1, 2025
Agent Licensed in PA
Answered by Rick Boyd on September 1, 2025
Broker Licensed in KY, AZ, CA & OH, TN, TX & UT
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.
Answered by Yasmery Vargas on April 15, 2025
Agent Licensed in PA
They’re often marketed that way because many plans have a $0 monthly premium, but you still pay in other ways:
What “$0 Premium” Actually Means:
-You still pay your Medicare Part B premium (usually deducted from Social Security).
-You pay copays for doctor visits, tests, and hospital stays.
-You pay for services as you use them — it’s pay-as-you-go instead of paying a large monthly premium.
Why They Can Offer $0 Premiums:
-The federal government pays the Medicare Advantage company a set amount each month to manage your care.
-That funding lets many plans reduce or eliminate the plan premium, but the costs show up elsewhere.
What You as the Client Should Understand:
-Your costs are not zero — they’re just structured differently.
-You trade lower premiums for higher out-of-pocket costs when you need care.
-Every plan has an annual out-of-pocket maximum, which Original Medicare doesn’t.
Answered by Kris Moen on December 24, 2025
Agent Licensed in ND
Answered by James Stang on September 24, 2025
Agent Licensed in OH
Answered by Dana Dane on April 2, 2025
Agent Licensed in OR, AZ, CA & 6 other states
When a Medicare beneficiary enrolls in a Medicare Advantage Plan (MAPD), the insurance company receives funds from Medicare to "manage" your health insurance plan. These funds are then used to pay for all aspects defined within a particular plan. If the plan has a "$0" monthly premium, it simply implies that the plan is fully funded as is, and no additional premium is required.
For plans that do have a monthly premium, the same principle applie,s only that additional funds are required to support the plan.
To entice Medicare beneficiaries to enroll in these plans, insurance companies offer many features and benefits not available from Medicare alone, such as Vision, Dental, Hearing Aids, Fitness membership and more.
Steven A James, MBA
Contact me.
Answered by Steven A James, MBA on November 26, 2025
Agent Licensed in WA, AK, AZ & 18 other states
Answered by Leslie Helene Sussman on March 31, 2025
Broker Licensed in NJ, FL & PA
Answered by Thomas Magnus, RHU on September 15, 2025
Broker Licensed in CA, AZ, NV, OR & WA
Answered by Cleo Martin on September 28, 2025
Agent Licensed in SC, FL, GA, MI & NC
Answered by Gus Karigan on November 4, 2025
Broker Licensed in IL, GA & MI
Answered by Robert Baez on April 11, 2025
Agent Licensed in IL, AZ, FL, OH & TX
Answered by Diana Salisbury on April 16, 2025
Broker Licensed in OH, IN & MI
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.
Answered by Abigail Turner on April 9, 2025
Broker Licensed in KS, AR, AZ & 14 other states
Answered by Frank Woerner on June 8, 2026
Broker Licensed in IN & IL
Answered by Lea Vollmer on October 30, 2025
Broker Licensed in IL, AL, AZ & 7 other states
What “$0 premium” means
A $0 premium usually means you do not pay an extra monthly fee to the private insurer for the plan itself. It does not mean all your care is free.
Costs you may still pay
• The Medicare Part B premium, which most people still owe.
• Copays and coinsurance when you use services.
• Deductibles on some plans.
• Higher costs if you go out of network or need services the plan limits.
Why plans advertise it
Insurers can offer a $0 premium because Medicare pays them a set amount to manage your coverage. They may use that funding to reduce the monthly premium while collecting money through cost-sharing when you get care.
Practical takeaway
A Medicare Advantage plan can be a good value, but only if the total cost and network rules fit your needs. The smartest comparison is not “free vs. not free,” but “what will I likely pay over the year?”
Answered by Hudson Albert on June 4, 2026
Broker Licensed in TN, AL, AZ & 20 other states
Answered by Aaron Solomon on March 27, 2025
Broker Licensed in OH, LA & TX
As long as you pay your Part B Premium to Medicare monthly you should be able to find a no cost Advantage plan. There are some plans that have nominal monthly premiums.. And you will likely have co-pays for many services on the plan, if not all the services.
Answered by Pauline Weiland on April 13, 2026
Agent Licensed in AZ, CA, MS, NV & TX
Answered by Cody Brown on March 28, 2025
Agent Licensed in MO, AL, AR & 10 other states
Answered by Lou Spatafore on March 2, 2026
Broker Licensed in WV, FL, GA & 10 other states
Answered by Stephanie Yarberough on March 17, 2026
Broker Licensed in PA
Answered by Nancy Courser on May 18, 2026
Agent Licensed in MI, FL & TN
Answered by Harold Randolph on March 28, 2025
Broker Licensed in MI, IN, KY & OH
Answered by Jessica Breland on April 9, 2025
Broker Licensed in LA
Answered by John Zentner on April 9, 2025
Agent Licensed in CA
Answered by Dina Todd on October 15, 2025
Broker Licensed in NC
Tags: Advice for Seniors Medicare Advantage The Medicare System
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