Want a $0 Premium Medicare Advantage Plan? Read This First!

Avoid Expensive Medicare Mistakes.

You’ve heard about Medicare Advantage plans that have a $0 monthly premium. And that sounds like a great deal, right? It may be and it may not be – but if you choose a plan based solely on premium costs you may actually end up paying more for your healthcare than expected.

Some Medicare Advantage plans do provide great coverage at a great price. But when you consider the fact that the average Medicare Advantage premium is roughly $20 per month1, the upfront savings aren’t all that significant compared to health care bills for what may not be covered if you spend a few more dollars upfront.

That's going to save them a lot of money...

"Many of the calls I get about Medicare plans are from people who are already convinced they want a zero premium plan because that’s going to save them a lot of money a month,” said Rick Papay, Lic. Medicare Agent & Supervisor. "But the truth is that you need to look at the deductibles, copays and coinsurance and covered services to figure out what plan will really save you the most money."

Why Zero Premium Medicare May Not Save You Money.

Of course, the plan premiums should be part of your decision making. But you also need to look at what you will pay for your health care to figure out what plan will really save you the most money.

When reviewing any Medicare Advantage plan, check the:

  • Annual Deductible:
    The amount you pay out of pocket before the plan begins to cover any costs.

  • Coinsurance:
    The percentage of the costs you pay for covered services

  • Providers:
    Does the plan charge more for out-of-network care? (This may not be an issue for you).

  • Prescription Drugs:
    Is there a separate deductible, and a copay or coinsurance cost?

  • Copayments:
    The set amount you pay when you receive medical care.

  • Part B Premium:
    Does the plan pay part or all of your monthly Part B premium (if not, you are responsible for paying your Part B premium, the monthly cost was $148.50 in 2021).

Speak with a Licensed Medicare Insurance Agent who can better understand your expected healthcare needs and match you with a plan that fits your needs and budget… and will help protect you if something unexpected should happen to you.

...the worst possible choice for you!

"There is no one best plan – the one that works perfectly for your sister or best friend may be the worst possible choice for you! It really comes down to your personal health, the type of care you are likely to need and your budget,” says Rick Papay, Lic. Medicare Agent & Supervisor.

Rick explains that picking a plan with a higher monthly premium and a very low deductible may be the right choice if you need regular healthcare. A plan with a low premium and a high deductible could be a better fit if you typically only get an annual checkup and don’t need many medications.

"It’s a shame that it’s so complicated, but the hard truth is that if you’re not familiar with all the options, and how Medicare works, it can be really difficult to select the right plan,” said Rick. "I feel like a lot of people just give up, and choose whatever plan will cost the least each month. But that’s not the way to do it – call me, and I can help!

Find the best plan for you!

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A lot of people avoid Medigap (otherwise known as Medicare Supplement) because they think it is expensive, but depending on your individual health care needs, you may end up saving a lot of money with a Medigap plan...especially when compared to Medicare alone.

Here’s are a few examples of how a Medigap policy can save you money….and when it may make sense to have one...

Traditional Medicare (Part A and Part B) pays only about 80%2 of the costs it approves for hospitals, doctors, and medical procedures. Paying the rest is your responsibility.

So let’s say you need a hip replacement. Averaging out quoted costs3, the total would be roughly $39,000 including the cost of the implant. With traditional Medicare you would be responsible for the 20% copayment (in this case, $7,800) and your annual deductibl 4. If you have a Medicare Supplement policy, those out of pocket healthcare costs are covered.

But you need to factor in the cost of your Medicare Supplement coverage, which varies widely depending on where you live, your sex and age and your health status. If you have a standard Plan G, one of the most popular plans, in zip code 10025 (New York City) the cost of standard Plan G coverage is $268-$476 5, and you have a total deductible of $203 per year.

Live in Miami? The same plan would cost you $220-$3536, monthly. You can also get a high deductible Plan G for $61-$112 a month (Miami, $268-$476 NYC) with a $2,370 total deductible per year.

So, you will save a bit on your costs for a hip replacement. And when you get into really costly medical procedures, like a coronary bypass ($86,000, your 20% copay would be $17,178)7, the savings add up.

What do the costs look like if you have a Medicare Advantage plan? Again, it depends on the particular plan you choose. But in general, you pay no or low monthly premiums but will have copays and/or coinsurance costs for many of the healthcare procedures you use. Your annual out of pocket cap for Medicare Advantage can be as high as $7,5508, but there is no limit to the out-of-pocket maximum you pay with Medicare.

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MedicareMD in partnership with WebMD

Bottom line, Medicare can be complicated. Speak with a Licensed Medicare Insurance agent and let them help you. Tell them about your expected health care needs, what benefits are most important to you and let them help find the best plan for you!

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Medicare is confusing!

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