What Are Medicare Part B Give Back Plans And Who Is Eligible
December 13, 2021 By Danielle Kunkle Roberts
With Medicare Part B premiums jumping to $170.10 in 2022, you may be looking for ways to lower your premiums and save money on your Medicare costs. The new Medicare Advantage giveback plans that provide the give back benefit may be a way to do just that by giving back a portion of your Part B premium. Find out how these plans work, what to watch for, and how to find one in your area.
Who Is Eligible For The Part B Give Back Benefit
To be eligible for a give back plan, policyholders must meet specific criteria. First, you must be enrolled in Medicare Part A and Part B and pay your own premiums. This means that if your premiums are currently being covered by a state or local program, you will not qualify.
Additionally, you must live within the service area of a plan that offers a premium reduction plan. Currently, there are 48 states in the U.S. that offer this benefit.
Keep in mind, give back plans work directly with Social Security, so, no direct payments are sent to you by the carrier.
Medicare Give Back Benefit
Seniors on Social Security with Medicare Advantage coverage may qualify for the Medicare Give Back Benefit. Here is what you should know.
The maximum benefit for 2022 is $148.50-per-month .
Give back benefits are for Medicare Advantage plan participants only.
NOT all Medicare Advantage plans qualify.
Medicare Open Enrollment is the ideal time to compare your plan and decide it it is the best option for the coming year.
Use the Associations free online directory to find a Medicare insurance broker who can offer information and compare your options.
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When Will I Get It
If youre eligible, you dont have to do anything to activate your giveback the monthly amount will be applied to your Social Security checks or Medicare Part B premium. However, if you recently switched to a new plan with a giveback, it could take a few months to kick in. When it does, youll be reimbursed for each month you werent compensated since joining your new plan.
How The Medicare Part B Giveback Might Save You Money
Medicare Advantage marketing touts Part B premium reductions, but they’re only available on certain plans, and may not be the plans that best fit your needs
Can’t wait to make changes to your Medicare coverage during open enrollment? Just know that open enrollment can also be an occasion for major enrollment blunders. Here are three that you’ll want to steer clear of.
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Exploring The Give Back Benefits Rise In Popularity
While the Give Back Benefit was first introduced in 2003, shows a significant spike in the number of searches for the Part B Give Back Benefit since 2020. Forbes also reported on increased interest in the benefit back in 2020. While there are a number of potential causes for the benefits rise in popularity, its hard to ignore the timing. The benefit reached peak popularity in 2020, the same year that marks the onset of the COVID-19 pandemic. The pandemic resulted in a lot of economic uncertainty, which is often paired with penny pinching.
Time will tell if this benefit will remain popular, but because of concern around inflation, there is no doubt that Americans nationwide will continue to prioritize saving.
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How Do Medicare Part B Give Back Plans Work
Medicare Part B Give Back plans are health plans offered by private insurance companies rather than Medicare.
Like other Medicare Advantage plans, beneficiaries enjoy Original Medicare Part A and Part B coverage benefits and usually some extra perks.
These bundled plans provide comprehensive coverage that reduces out-of-pocket costs for hospital treatments, doctors visits and other outpatient healthcare services. Additional benefits such as prescription drug coverage are also typical features.
The Give Back initiative is another one of the supplemental benefits that set these plans apart. The insurance company pays for all or part of the Part B premiums on their members behalf, representing a considerable saving each month.
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Medicare Give Back Benefit By Zip Code
On its website, Medicare allows you to search for plans offering the Medicare give back benefit by zip code. Youll need to sift through all of the Medicare Advantage plans available in your area and find the ones that offer give back benefits. But remember this is just one of the benefits you should base your decision on. Before you purchase a Medicare Advantage plan with a give back benefit on your own, ask yourself a few questions:
- Are my doctors covered?
- Do I need prescription drugs, and does this plan offer my medications through Part D coverage?
- How do the out-of-pocket costs like copayments and the deductible compare to other plans in my area?
- Do other plans have more of the benefits I need like dental, vision and hearing, or meal delivery and transportation?
Will a plan with give back benefits fit your needs? To find out, give GoHealth a call. Our licensed insurance agents will guide you through your options and help figure out whether these plans are just right for you.
What extra benefits and savings do you qualify for?
What Is The Medicare Part B Giveback
If you choose to enroll in a Medicare Advantage plan, you pay the premium for Part B plus the premium for the Advantage plan. As of 2023, two-thirds of all Advantage plans have $0 premiums, which means their enrollees just pay the Part B premium.
But some of those plans go a step further, offering giveback rebates that pay a portion of their enrollees Part B premiums. This benefit, also referred to as a Medicare Part B premium reduction, has been available since 2003. And although most Advantage plans do not offer a giveback rebate, the benefit has become more popular and widespread in recent years, and is increasingly marketed as a stand-out benefit by Medicare Advantage plans that do offer it.
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How Do I Decide If A Medicare Advantage Plan With A Part B Give Back Is Right For Me
Its wise to remain levelheaded when choosing your Medicare health plan. While having a bit of a reprieve on your monthly Part B premium sounds good, several factors should be considered. Lets talk about a few items that have more impact than the Part B give back benefit.
Prescription Drug Coverage
When you choose a Medicare Advantage plan, one of the most important things to check is how well the plan covers your medications. Every program has a different formulary, meaning that all plans have different prescription costs. It wouldnt do much good to enroll in a plan that offers a give back of $144 if your drug costs are considerably more.
For example, if you have insulin-dependent diabetes, a giveback plan may not participate with the senior savings model. In this case, you could pay more drug costs than your monthly savings on Part B reduction.
Healthcare provider copays
If you have providers you want to keep, they may not be covered on the give back plan. You should review with a licensed agent to ensure your doctors take the plan. In addition, your copay for the doctors office visits may be more on the give back plan vs. other options. You must weigh the part B reduction savings against the higher copays.
Out-of-pocket costs
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Which Companies Offer Medicare Part B Premium Reduction
A variety of carriers offer give back plans. However, the list of carriers with available plans offering this feature differs depending on your location. The most popular carriers that offer a premium reduction are Humana, Cigna, and Aetna among others.
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In the summary of benefits or evidence of coverage, youll see a section that says Part B premium buy-down. In this section, you can see how much of a reduction you receive from your plan. However, if you are not able to locate this, call the customer service number on the back of your card or contact your licensed agent to receive assistance in understanding the give back you will be receiving.
It is important to review all Advantage plans and carriers available in your area to maximize your chances of finding a give back plan to enroll in.
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Did You Know That Medicare Plans Offer More Benefits Than Just Medical Assistance
If youre familiar with Medicare, or youre enrolled in the system, you may already know that Medicare plans offer a variety of medical benefits geared toward helping you receive the best healthcare available to you. However, you may not have known that Medicare plans can offer certain benefits that can help you in other ways. One such benefit is the Medicare Give Back benefit.
As your go-to resource for all things related to Medicare, its our goal to help you learn about other helpful benefits that a Medicare Advantage plan can offer. Today, well be going over the $144 Medicare Give Back benefit.
How Do Medicare Advantage Plans Work
A Medicare Advantage is another way to get your Medicare Part A and Part B coverage. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by Medicare-approved private companies that must follow rules set by Medicare. If you join a Medicare Advantage Plan, you’ll still have Medicare but you’ll get most of your Part A and Part B coverage from your Medicare Advantage Plan, not Original Medicare.
These “bundled” plans include
, and usually Medicare drug coverage .
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How Do You Know How Much Youll Get Back
Insurance providers detail how much they give you for a Medicare Part B premium give back in their summary of benefits or evidence of coverage.
In the Part B premium buy-down section, youll see the percentage of the premium that the insurance carrier pays. It may state 100% or a lesser amount.
The most youll get back is the full standard Part B premium amount of $170.10 in 2022. If youre unclear on the offer, contact your insurance agent or the carriers customer care line via the number listed on the back of your card with any questions.
Whats The Difference Between A Part B Give
Both of these benefits refer to Medicare Advantage plans. When you enroll in Medicare Part C, you must pay your monthly Part B premium. When you hear zero premium, the Medicare plan doesnt have an additional monthly cost.
Medicare Advantage plans that provide the benefit generally have a zero-premium. The difference is that your monthly Part B premiums would be reduced by the give-back amount provided by your plan.
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What Exactly Is The Program
The Medicare Give Back Benefit is actually a Medicare Part B premium reduction, or buy down.
Only some Medicare Advantage plans qualify or include the buy down. Simply explained, the federal government pays Advantage plans to provide covered care for plan enrollees. Medicare doesnt pay individual claims the MA provider covers the cost. The insurance company pays back some of the amount to Medicare. This amount is paid back to you in your Social Security benefit,
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Medicare Advantage Policy Disclaimers
All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation. The Cigna name, logos, and other Cigna marks are owned by Cigna Intellectual Property, Inc. All clinical products and services of the LivingWell Health Centers are either provided by or through clinicians contracted with HealthSpring Life & Health Insurance Company, Inc., HealthSpring of Florida, Inc., Bravo Health Mid-Atlantic, Inc., and Bravo Health Pennsylvania, Inc. or employees leased by HS Clinical Services, PC, Bravo Advanced Care Center, PC , Bravo Advanced Care Center, PC and not by Cigna Corporation. The Cigna name, logos, and other Cigna marks are owned by Cigna Intellectual Property, Inc. All pictures are used for illustrative purposes only.
Cigna contracts with Medicare to offer Medicare Advantage HMO and PPO plans and Part D Prescription Drug Plans in select states, and with select State Medicaid programs. Enrollment in Cigna depends on contract renewal.
Medicare Supplement Policy Disclaimers
Medicare Supplement website content not approved for use in: Oregon and Texas.
AN OUTLINE OF COVERAGE IS AVAILABLE UPON REQUEST. Well provide an outline of coverage to all persons at the time the application is presented.
American Retirement Life Insurance Company, Cigna National Health Insurance Company and Loyal American Life Insurance Company do not issue policies in New Mexico.
Exclusions and Limitations:
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How Does A Part B Giveback Rebate Work
The specifics of the giveback rebate rules are outlined in federal regulations that have been applicable since Medicare+Choice plans were rebranded as Medicare Advantage. Medicare Advantage plans receive payments from the federal government . But the plan can opt to receive a reduced payment and use the payment reduction to offset some of the Part B premium for its enrollees.
How Do I Qualify For The Giveback
You may qualify for a premium reduction if you:
- Are enrolled in Part A and Part B
- Do not rely on government or other assistance for your Part B premium
- Live in the zip code service area of a plan that offers this program
- Enroll in an MA plan that provides a giveback benefit
Because not all plans offer this benefit, it’s important to do your research and compare plans, benefits, and costs to ensure you’re making the best decision for you.
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What Does Medicare Pay For
Medicare provides healthcare coverage to those 65 and older, as well as people with disabilities and some chronic diseases, through five major options:
- Basic hospitalization coverage through Medicare Part A.
- Outpatient treatment, such as doctor visits and diagnostic tests, is in Medicare Part B.
- Part C is a private option that combines Part A and Part B coverage while also providing additional benefits.
- Prescription drug coverage comes under Medicare Part D.
Things To Consider Before Choosing This Type Of Plan
This sounds really enticing especially when youre on a fixed income. But there are some things to consider first before choosing a plan with a Give Back Benefit.
You want to compare all the benefits including:
- Co-pays for services
- The annual maximum out of pocket for the plan
- Your prescription costs
- Make sure your doctors are in the network
If the costs are much higher than compared to another plan, the monthly Give Back may not be worth it. You may be able to get another plan that will provide a much better value in the long run. You definitely want to compare plans to see what makes the most sense for your situation.
Some people qualify for assistance through the Medicare Savings program, where the government pays for their Part B monthly premium. If the government pays your Part B premium, then youre not eligible for a Give Back benefit since you already get help paying for Part B.
You may want to know if theres an option for a Give Back Benefit in your area. So give us a call at 783-5901 and well be happy to show you whats available and compare your options.
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Drug Coverage In Medicare Advantage Plans
Most Medicare Advantage Plans include prescription drug coverage . You can join a separate Medicare drug plan with certain types of plans that:
- Cant offer drug coverage
- Choose not to offer drug coverage
Youll be disenrolled from your Medicare Advantage Plan and returned to Original Medicare if both of these apply:
- Youre in a Medicare Advantage HMO or PPO.
- You join a separate Medicare drug plan.
Note:
What Is A Medicare Give Back Benefit
Medicare Part B Give Back plans are health plans offered by private insurance companies rather than Medicare.
Like other Medicare Advantage plans, beneficiaries enjoy Original Medicare Part A and Part B coverage benefits and usually some extra perks.
These bundled plans provide comprehensive coverage that reduces out-of-pocket costs for hospital treatments, doctors visits and other outpatient healthcare services. Additional benefits such as prescription drug coverage are also typical features.
The Medicare give back benefit is another one of the supplemental benefits that set these plans apart. The insurance company pays for all or part of the Part B premiums on their members behalf, representing a considerable saving each month.
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How Does The Medicare Part B Give
Once you enroll in a Medicare Advantage plan that provides the Part B give-back benefit, the program youre enrolled with will coordinate with Social Security. They will automatically apply the reduction of the premium.
If your Medicare premiums are deducted automatically, youll notice the deduction is lower. If you send a check to pay for your Part B premium, your bill will reflect a reduced amount. You can use Medicare Easy Pay to pay any balance.
How Do Beneficiaries Receive The Funds
The Part B Giveback is credited monthly on the beneficiariesâ Social Security check. Judy Gee, a Broker Relationship Manager with Humana, explains that it can take a few months for the Giveback to be processed which could result in the member receiving a lump sum amount on their Social Security check to include the months prior to activation. Then, the specific dollar amount of the benefit will be credited monthly through Social Security.
For example, during Annual Enrollment Period , a beneficiary is enrolled in an MA plan featuring a $50 Part B Giveback. Their coverage goes into effect, January 1, however it will take two months for the Giveback benefit to become active. The first Social Security check upon successful enrollment and active coverage will include $100 . Moving forward, the beneficiary will see the designated $50 Giveback on their check each month.
Just the same as activation of the benefit, deactivation of the Giveback can take a few months. So, if it takes two months for the disenrollment to be acknowledged by CMS and Social Security, the member will receive a check with the overpayment for the two months subtracted.
Editorâs Note: This post was originally published in February 2020 has been updated to reflect current statistics.
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