I don't understand how my friend pays nothing for their plan and I pay over $200-are these plans just totally random by ZIP code?

Answered by 9 licensed agents

The plans are not random. If your friend pays nothing for his Medicare plan, this is highly likely to be a Medicare Advantage plan featuring deductibles, copays and coinsurance depending on the plan. Most advantage plans feature a $ 0-dollar copay to see your primary doctor but will have a $30-to-$ 50 dollar copay to see a specialist and there will be additional costs depending on what's going on. Now if you are paying over $ 200 for your plan, you may have a very high-benefit Advantage plan but it is more likely that you have a Medicare supplement plan and this is a different animal. Medicare supplement plan F pays after Medicare leaving you with no medical bills for health services for Medicare-approved services (or no bills after a 2025 $ 256 outpatient deductible if you have a supplement Plan G). Talk to your independent insurance agent about all this otherwise get your license and help me explain this stuff!

Answered by Clarence "Mark" Christiansen on April 3, 2025

Agent Licensed in WI, AZ, CA & 16 other states

Answered by Clarence "Mark" Christiansen Medicare Insurance Agent
No. Plans are not random by zip code. Without further information, it seems you may have a Medigap plan with a monthly premium and your friend has a Medicare Advantage plan with NO monthly premium.

Answered by William Lawler on April 7, 2025

Broker Licensed in MO, FL, IA & 12 other states

Answered by William Lawler Medicare Insurance Agent
Medicare plans are available based upon zip code but there are many types of plans available. Basically, there are three type of products that people can enroll in addition to Original Medicare. The three type of plans that are available are Medicare Supplement plans (also referred to as Medigap plans), Prescription Drug Plans, and Medicare Advantage Prescription Drug plans. Medicare Supplement plans do carry a premium whereas some Medicare Advantage Prescription Drug Plans may not carry a premium. Most likely, you are enrolled in a Medicare Supplement and your friend is enrolled in a Medicare Advantage Prescription Drug plan. It is, however, quite possible to be enrolled in a Medicare Advantage Prescription Drug plan that does carry a high premium. In order to best understand what coverage you have always reach out to a local broker for a quick review. Lastly, it is also possible to be enrolled in a zero premium Prescription Drug plan or a plan with a very high premium. Always check your cards and always reach out to a local broker for assistance.

Answered by David Quintal on April 8, 2025

Broker Licensed in NH, AL, AZ & 14 other states

Answered by David Quintal Medicare Insurance Agent
In Maryland ZIP CODES mean nothing as elates to Plan Options because zip codes cross County and City boundaries. In fact when speaking with friends or relatives yo can never compare what they pay with what you pay unless you see the same Doctors, take the same Prescriptions, use the same Pharmacies, have the same health issues, and have the same "risk level" and budget for your Health Care Plan.

Health Care is unique to every individual and even a Husband and Wife may have different needs and therefore different Plans.

Answered by John L Herman Jr on April 2, 2025

Broker Licensed in MD, DE & PA

Answered by John L Herman Jr Medicare Insurance Agent
The best way to discuss that is to sit down and look at what your plan is. If your friend is comfortable, I’m happy to look at her cards and tell you the difference between the two plans. There are so many plans out there. It’s hard to say

Answered by Shelly Hefley on April 16, 2025

Broker Licensed in IN, AL, IL, KY & TN

Answered by Shelly Hefley Medicare Insurance Agent
You don't understand private Medicare Insurance Plans unfortunately. There's Medigap Insurance plans & Medicare Advantage plans. Please see www.locatemedicareinsurance.com

Thank you.

Andrew J. Zurbuch, MBA

Licensed Broker

Integrated Financial

[email protected]

Plans are insured or covered by a Medicare Advantage (HMO, PPO and PFFS) organization with a Medicare contract and/or a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

Answered by Andrew Zurbuch, MBA on April 8, 2025

Broker Licensed in IN, FL, KY, MO, OH & TN

Answered by Andrew Zurbuch, MBA Medicare Insurance Agent
Plans, depending on exactly what plan you're talking about, are priced based on your zip code, your age, your sex, and then discounted based on your income level.

Answered by Steve Brauer on April 16, 2025

Broker Licensed in AZ & CA

Answered by Steve Brauer Medicare Insurance Agent
More than likely you have a Medicare Supplement plan and your friend has a Medicare Advantage plan. Medicare supplement plans require a monthly premium, whereas a very large majority of Medicare Advantage plans are offered at a zero - $0-dollar monthly premium. In addition, Medicare supplement plans also require purchasing a stand-alone prescription drug plan where most Medicare advantage plans combine the prescription drug portion all into one plan.

Answered by Mel Stevens on April 17, 2025

Broker Licensed in AZ

Answered by Mel Stevens Medicare Insurance Agent
That’s a great question, and you’re not alone—lots of people wonder the same thing!

Plans can seem totally random, but there are a few reasons your friend might be paying nothing while you’re paying over $200:

1. Location matters. Insurance companies offer different plans based on ZIP code. Some areas just have better deals than others.

2. They might get extra help. If your friend qualifies for Medicaid or other programs, their costs could be much lower—even $0.

3. Different plan choices. Your friend might’ve picked a plan with fewer extras or a smaller network, while yours may include more coverage or more doctors.

4. Companies compete differently. Some insurance companies offer really low-cost plans in one area but charge more in another.

So no, it’s not totally random

Answered by Brandon Brown on April 18, 2025

Agent Licensed in KY

Answered by Brandon Brown Medicare Insurance Agent

Tags: Advice for Seniors The Medicare System

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