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Thinking About a $0 Premium Medicare Advantage Plan?


As you consider the cost of health insurance in retirement, $0 premium Medicare Advantage plans may seem like a perfect option. They provide Original Medicare (Part A and Part B) plus extra coverage, with no monthly payment. So, what’s the catch?

With $0 premium plans, there are some costs to consider. While you won’t pay a monthly premium for your Medicare Advantage, you’ll still be responsible for your:
        • Part B monthly premium (In 2019, $135.50 or higher depending on your income)
        • Annual deductibles
        • Coinsurance and copays

For many retirees, $0 premium Medicare Advantage plans make sense. Almost half of Medicare Advantage enrollees do not pay a monthly premium. To find out whether a $0 premium Medicare Advantage plan is the perfect choice for you, consider these questions:

Can you handle higher out-of-pocket costs for Medicare Advantage? 

Medicare Advantage plans vary when it comes to the amount you’ll pay for deductibles, coinsurance, and copayments. One thing is certain. You can expect those out-of-pocket costs to be higher if you are not paying a monthly premium.


The biggest factor is your comfort level. This plan works if you prefer to have extra money each month and can handle higher health care payments when they arise. If you’d rather budget for health care each month and not worry about surprises, a $0 premium plan may not be for you.

What services will you need covered by Medicare Advantage?

To see the effect of those higher costs on your budget, determine how much care you’ll need and how often. If you have a chronic condition or expect many health care visits and procedures, those out-of-pocket costs will add up.

The good news is that Medicare Advantage offers flexibility. Don’t worry if your health needs change or you find yourself uncomfortable with the unexpected costs of a $0 premium plan. Simply choose a new plan for the following year. You can change your plan once a year during open enrollment without regard to your age or medical condition. Open enrollment takes place from Oct. 15 through Dec. 7.

Will you stay within your Medicare Advantage network? 

With any Medicare Advantage plan, choosing in-network providers minimizes out-of-pocket costs. Those choices have an even bigger impact with $0 premium Medicare Advantage plans and their higher copays.

Take a look at your preferred providers. Check them against the provider networks of the $0 premium plans you’re considering. If you won’t be staying in-network, the $0 premium plans may cost you more throughout the year.

How much will you be traveling with your Medicare Advantage plan?

If you plan to travel with Medicare, it’s important to determine the type of traveling you’ll be doing. Day trips or weekend getaways mean that you can still get your health care in your home region. If your traveling will be extensive, consider the cost of medical care outside of your network.

While it would be nice to pocket that premium payment each month for travel expenses, a $0 premium plan may not be your best option. Weigh the cost of monthly premium payments against out-of-network, out-of-pocket costs. Whether you end up choosing a Medicare Advantage plan with or without a premium, rest assured that your plan is providing more coverage than Original Medicare.

 

Turn to the experts at Highmark

To learn more about your Medicare Advantage options, schedule a personal consultation with a Highmark insurance agent or call 844-785-1796 (TTY users may call 711)

8 a.m. - 8 p.m. seven days a week