How can Medicare Advantage plans have a $0 premium? Where does the money come from?

Answered by 10 licensed agents

Medicare pays the insurance companies a certain amount per member per month and transfer responsibility of care to the plan. In exchange, the plans must offer actuarial benefits equivalent or better than Original Medicare

Answered by Dino Pappadis on April 27, 2026

Broker Licensed in FL

Answered by Dino Pappadis Medicare Insurance Agent
Medicare advantage plans with zero premium do exist. All Medicare advantage plans get a subsidy payment via the center for Medicare Medicaid services when a member belongs to a certain carrier.

Answered by Chris Vari on April 27, 2026

Agent Licensed in PA

Answered by Chris Vari Medicare Insurance Agent
The government gives certain amount of money to Heath Insurance companies and value care providers. They are responsible for managing the patience's health and the money given to them by the government to provide best health service.

Answered by Rukshini Sandrasegaran on April 27, 2026

Broker Licensed in AZ

Answered by Rukshini Sandrasegaran Medicare Insurance Agent
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Answered by Duane Boebel on May 18, 2026

Broker Licensed in AL, FL, GA & 9 other states

Answered by Duane Boebel Medicare Insurance Agent
Medicare Advantage plans aren’t “free.” The government pays private insurers a fixed amount for every person enrolled, and that money is what the plan uses to run its benefits. Because they’re already getting that funding, some companies choose not to charge an additional monthly premium. Instead, they make up the difference through things like copays, deductibles, and network rules.

Answered by Aaron Fielding on April 27, 2026

Broker Licensed in CA, OR & TX

Answered by Aaron Fielding Medicare Insurance Agent
Medicare does not pay anthing towards Medicare Advantage plans, therefore Medicare pays the carrier to handle 100% of the claim. Carriers can earn extra money based on their star ratings. Because they are being paid by Medicare to pay for your health care, they can offer $0 premium. You will have out of pocket expenses for some things.

Answered by Lori Crivelli on April 27, 2026

Broker Licensed in CA, AZ, FL & 6 other states

Answered by Lori Crivelli Medicare Insurance Agent
$0 premium Medicare Advantage plans are possible because private insurers receive monthly, government-funded payments for each member.

These companies cover costs by managing care, limiting networks, and charging copays for services, rather than charging members a monthly fee.

Answered by Monica Hughes on April 27, 2026

Agent Licensed in LA, AL, AR & 16 other states

Answered by Monica Hughes Medicare Insurance Agent
Medicare Advantage plans can show a $0 premium because Medicare is basically paying the insurance company behind the scenes. Medicare sends them a set amount every month for each person on the plan, and if the plan doesn’t spend all of that on admin and benefits, they can use the leftover to drop your premium to $0 or even lower.

The amount Medicare pays changes by county, which is why some areas have tons of $0 plans and others barely have any.

And just to be clear — $0 premium does not mean $0 cost. You’ll still have copays, coinsurance, and out‑of‑pocket costs when you actually use the plan. It just means you’re not paying a monthly premium on top of that.

Answered by Stephanie Floyd on May 4, 2026

Agent Licensed in TX, AL, FL & MI, OH, SC & VA

Answered by Stephanie Floyd Medicare Insurance Agent
Medicare allows a certain amount of funds to carriers that they then use to provide benefits to their recipients. The plans typically have a $0 monthly premium with copays for services such as doctors appointments and hospital visits

Answered by Jasmine Jones on April 27, 2026

Broker Licensed in VA, AL, AR & 20 other states

Answered by Jasmine Jones Medicare Insurance Agent
Hi,

Thank you for your question, Medicare Advantage plans are paid from Medicare and with the payment the plan receives they are responsible for your medical needs.

Answered by Jim Kaefer on April 27, 2026

Broker Licensed in NC & CA

Answered by Jim Kaefer Medicare Insurance Agent

Tags: Medicare Advantage

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