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What Is The Give Back Benefit On Medicare Advantage Plans

How Do Beneficiaries Receive The Funds

Medicare Part B Give Back Benefit – What’s The Catch?

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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What If My Medicare Advantage Plan Stops Participating In The Medicare Give Back Program

Every year, Medicare issues an Annual Notice of Change , which arrives by the end of September. Your plan will inform you if it will continue participating in this program.

Suppose your plan no longer offers the Medicare Give Back Program. In that case, you can switch to another Medicare Advantage plan that has it during the Annual Enrollment Period or the Medicare Advantage Open Enrollment Period .

Read Also: Is Social Security Benefits Exempt From Garnishment

Who Is Eligible For A Medicare Part B Premium Reduction

Are you wondering who qualifies for free Medicare B? There are many people who might be eligible for a Part B premium reduction, and you could be one of them. To be eligible, you need to be enrolled in a participating Medicare Advantage plan. Not all plans provide this benefit. Similarly, not all plans are offered in all areas. The plans available vary by state and county, so you will need to find a plan whose service area includes your location that offers the Part B give back benefit. You might find that no plans in your area provide this benefit. Currently, plans that provide a give back benefit exist in 48 states.

To qualify for a premium reduction, you need to be enrolled in both Medicare Part A andMedicare Part B. You must also pay your own Part B premium each month. If you have completed enrollment in another type of assistance program, such as Medicaid, that helps pay your Part B premium, you will not be eligible to participate in the give back benefit. Similarly, those participating in a Medicare Savings plan will not be eligible for the give back benefit. Most Medicare beneficiaries will be able to participate in the give back benefit once they find the right Medicare Advantage plan, with the exception of those who already receive Part B premium assistance from other sources.

What Is The Part B Premium Reduction Benefit

United Healthcare: Medicare Give Back Benefit Zip Codes

When you’re enrolled in Medicare Part B, you must pay a monthly premium of $170.10. The giveback benefit, or Part B premium reduction, is when the Part C Medicare Advantage plan reduces the amount you pay toward that premium. Your reduction could range from less than $1 to the full premium amount.

Even though you’re paying less for the monthly premium, you don’t technically get money back. Instead, you just pay the reduced amount and are saving the amount you’d normally pay.

If your premium comes out of your Social Security check, your payment will reflect the lower amount. If you don’t pay that way, the giveback benefit would be credited to your monthly statement. Instead of paying the full $170.10, you’d only pay the amount with the giveback benefit included.

For example, if you typically pay $170.10 per month but your MA plan’s giveback benefit is $50, you don’t get $50 back each month. Instead, you’d only pay $120.10 per month, keeping that $50 in your wallet. If your plan offers a full $170.10 refund, you wouldn’t have a Part B monthly premium to pay.

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How Does A Give Back Benefit Work

If you get a Social Security benefit, then you will see an increase in your check every month. The Part B premium deduction will be lower.

So for an example, if your Part B costs $148.50 per month and your Give back credit is $70.00 per month, then you would see an increase of $70 in your monthly check.

Your Part B payment out of your pocket would drop to $78.50 instead of $148.50.

If you dont receive a Social Security benefit then youll pay for your Part B another way. The amount of the Give Back will reduce your monthly Part B premium bill.

Who Qualifies For The Give Back Benefit

  • 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.

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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?

Gomedicare Medicare Advantage Insurance Review

Give Back Benefit – What Is It and How Does It Work?
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Alterations To Your Medicare Advantage Plan Can Change Your Ability To Continue Receiving A Premium Reduction

Like anything in life, this benefit isnt set in stone once you receive it. Private insurers must follow Medicares rules regarding coverage, but they all have freedom to change the fees they charge for:

  • Coverage premiums
  • Covered services

This gives them the freedom to offer the Medicare Part B Give Back reduction one year, and then change that policy the next. They can only make this change once a year, on January 1, so be sure to review your plan after January 1 for any changes. This way, if you prefer to keep a Give Back benefit, you can compare plans offering the Medicare Give Back benefit by zip code and make the switch once Open Enrollment starts on October 15.

Who Should Consider A Medicare Giveback Plan

You may want to consider a Medicare giveback plan if you:

  • Are already planning on enrolling in a Medicare Advantage plan
  • Live in a zip code covered by a plan that offers a giveback program
  • Understand that you may not get all your Part B premium reimbursed, and this program is not the only factor in choosing a plan

When youre ready, a knowledgeable Medicare agent can help you understand your options.

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Is There An Income Requirement For The Give Back Benefit

No, there is no income test for the giveback benefit. Anyone eligible to enroll in Medicare Advantage can buy any Medicare giveback plan sold in their area. However, you must pay your own Part B premium. If you get premium assistance from Medicaid or another source, you arent eligible for the giveback benefit.

Plus Prescriptions Transportation Meals And More All At No Additional Cost

Medicare Advantage Giveback Zip Codes

Disclaimer Fine Print

The fine print in the red circle on this screenshot says

Plan availability varies by region and state. Transportation to plan-approved locations.

Extra benefits require enrollment in a Medicare Advantage Plan.

Again, this is available if you actually qualify for the low-income subsidy, then the monthly savings could add up. But only the beneficiaries of Medicare that get the low-income subsidy can get some assistance to pay the monthly premiums, coinsurance, copayments, and monthly premium for their Part D.

Many people do qualify for the Medicare Extra Help savings and dont even realize it.

To correctly calculate your eligibility for the low-income subsidy, Medicare doesnt count any resources like your home, insurance policies, or car. So for you to find out if you qualify, the best way is to apply.

The requirements are if your assets and annual income limits are below the eligibility threshold. These limits could change yearly, so you should check the most recent levels and pinpoint more accurately the requirements online at Medicare.gov.

Many prefer a Medicare Advantage Plan because coverages include a prescription drug program, dental, vision, and hearing care bundled together under one plan. These plans often have lower monthly premiums depending on the coverage of the plan.

Learn the basics of Medicare and how it all worksbefore you shop.

Medicare 101

Explore health and wellness topics focused on older adults.

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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,

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

Other programs that assist with Medicare Part B premiums

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What Is A Medicare Part B Premium Reduction Plan

The Part B premium reduction is when a Medicare Advantage plan reduces the amount you pay toward your Part B premium. The reduction could range from less than $1 to the full premium amount. This giveback benefit means youre paying less for the monthly premium, but it doesnt mean you get the money back.

Exploring The Give Back Benefit’s Rise In Popularity

Medicare Advantage Give Back Benefit (Part B Reduction Plans)

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 benefit’s rise in popularity, it’s 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.

Read Also: Applying For Social Security Benefit

Around 40% Of Medicare Advantage Plans Have No Monthly Premium But Did You Know Some Plans Actually Reduce Your Part B Premium

The Medicare giveback benefit, or Part B premium reduction plan, is becoming more available and popular among beneficiaries. Though not an official Medicare program, this benefit is offered by some Medicare Advantage plans and covers some or all of your Part B monthly premium .

While not all plans offer this benefit, it’s possible to find one where you’d pay a reduced premium amount up to $170. This can help maximize your savings while on Medicare, though there are a number of considerations when deciding if these plans are right for you. Read on to learn more about the giveback benefit and how you could qualify.

How Do I Receive The Medicare Giveback Benefit

You will not receive checks directly from your Medicare Advantage plan carrier. You can get your reduction in 2 ways:

  • If you pay your Part B premium through Social Security, the Part B Giveback will be credited monthly to your Social Security check.
  • If you dont pay your Part B premium through Social Security, youll pay a reduced monthly amount directly to Medicare.
  • Read Also: Are Social Security Benefits Taxable After Full Retirement Age

    How Does Part B Premium Reduction Work

    First, you must be eligible for and enrolled in Medicare Parts A and B. And you must already be paying the full amount for your Part B premiums. You wont qualify for the Part B Give Back benefit if you receive government assistance that pays for your Part B premiums.

    Next, you select and enroll in a Medicare Advantage plan that offers the Part B premium reduction benefit.

    Its important to note that only Medicare Advantage plans offer this premium reduction benefit. And it may not be offered where you live. While there are 48 states offering plans, they wont be available in every county across the U.S. Some areas have no plans at all.

    It should also be noted that Medicare supplements currently do not offer any giveback provisions. This benefit is only available if you enroll in certain Medicare Advantage plans. And, of course, there are only certain windows when you can shop for and enroll in a Part C Medicare Advantage plan.

    Medicare Give Back Benefits Arent Offered In My Area How Can I Save Money On My Medicare

    2020

    If you have Medicare Advantage , you may be able to switch to a new Part C plan that has a lower premium. If you pay a monthly premium for your Medicare Advantage plan, you may be able to switch and save most Americans have access to plans in their area that feature no-cost premiums.

    If income is a concern, you may qualify for dual eligibility in both Medicare and Medicaid. Medicaid is health insurance for Americans with low income. Qualifying for dual eligibility often allows you to enroll in a D-SNP, or Dual Eligible Special Needs Plan. With these plans, your state will often help pay a portion of your Medicare costs. But because Medicaid is partially run by the states, eligibility will depend on where you live.

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