You may be wondering why some Medicare Advantage plans are free (zero-dollar premium) and some are not. The reason is generally the total cost of care. A plan with a zero-dollar premium simply means that the amount the plan is compensated by Medicare, together with a member’s monthly Part B premium, is enough to cover the cost of care.
When looking at a free Medicare Advantage plan, you may want to consider whether the plan will cover the same doctors and medications that you currently use. If you can’t afford to pay for the extra coverage, you may want to look into a plan with a monthly premium.
Copays
In Medicare Advantage plans, members will typically pay a copayment for medical services. These payments are usually a set amount of money and can range from $10 to $45 per visit. Medicare Advantage plans also charge copays for some prescription drugs, some of which may be very high.
Copays on Medicare Advantage plans can vary a great deal depending on your location and your plan. But in general, you can expect to pay a total amount of around $5,200 per year for in-network services and about $9,200 for out-of-network services. Nevertheless, there are ways to reduce your monthly out-of-pocket costs.
Coinsurance
Depending on the type of plan you choose, some Medicare Advantage plans are free while others require a monthly premium. Although some Medicare Advantage plans do not require a monthly premium, you must still sign up for Medicare Part A and Part B and pay your Part B monthly premium. Each plan has a different limit on how much you must pay out-of-pocket for covered services during any given year. The limits can also change annually.
The value of the Medicare Advantage plan’s CMS rebate depends on its bid and star rating. The higher the star rating, the larger the rebate. These dollars can be used to lower the cost of services for members and cover their Part B premiums. They can also be used to contract with in-network providers and receive discounted services.
Preventive care
Free preventive care is important to stay healthy. This care can help you avoid health issues and avoid costly medical bills. It is also very important because preventive care can help you catch diseases early. For example, cancer claims half a million lives every year in the U.S. It is the second leading cause of death in the country and one in four people will develop the disease at some point in their life.
Preventive care services include screenings, vaccinations, and counseling. Most preventive services under Original Medicare are free or low-cost and require no co-payment or deductible. Medicare Advantage Plans also cover many preventive services for no cost.
Disease management
Medicare Advantage plans are private health plans administered by the federal government that give Medicare beneficiaries added benefits. The programs have lower premiums and offer disease management services to help patients stay healthy. Some plans cover disease management services as a free benefit, while others require a copayment.
If you have chronic illnesses, you should check whether a particular plan includes supplemental benefits for disease management. The insurer determines eligibility based on questionnaires and claims data.