Who Can Join A Medicare Advantage Plan
Beneficiaries who have Medicare Part A and Part B can join a Medicare Advantage plan if they also:
- Live in the service area of the plan they want to join
- Are a U.S. citizen or legal resident who has lived here for at least 5 years
Not all Medicare Advantage plans are available in all areas. Most plans have a designated service area, or specific cities or zip codes, where they offer coverage. You must live within that service area in order to enroll in that plan.
If you live in another state for part of the year, or are curious about a plans service area, contact the plan directly.
Does My Zip Code Impact My Medicare Options
Zip code does affect which plan options are available to you. For example, Medigap and Medicare Advantage plans will vary in pricing as well as features depending on your location. Additionally, you must live in the plans service area to be eligible for enrollment.
Medicare Advantage plans are impacted most by zip code changes. Did you know Medicare Advantage plans dont cover you outside the service area? So, in many cases, when you leave the service area you no longer have coverage.
Also, Medicare Advantage plan premium costs are cheaper in metropolitan areas, and more expensive in rural areas. Some areas may offer policies with a larger network of doctors or more ancillary benefits.
Since Medicare Supplement plans are standardized, they have the same coverage in all states, except for Wisconsin, Massachusetts, and Minnesota. Pricing will vary greatly depending on your zip code.
If you want a policy that allows you to have coverage in another state, Medigap would be a good option for you.
How To Find A Plan That Offers The Giveback Program
To find a plan, you can use our Find a Plan tool. In the Plan Details, under the “premiums” section, look for plans that have a “Part B premium reduction” listed. The amount shown is how much the premium giveback amount is.
Depending on how many Medicare Advantage plans are available in your area, you may have several options to choose from. Some zip codes have only one or two plans, while others may have dozens to research.
Even if you find a plan that offers the giveback program, it’s important to compare other factors as well in order to find the best plan and options for your unique needs. Other items to consider include:
These are just a few factors to consider when comparing plans. Take time to carefully compare plans in your zip code and all the features of the plan, not just the giveback program.
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How To Find Supplemental Medicare Plans In My Zip Code
Whether youre moving a county over or across the country, its important to know the new options available to you. In some instances, like moving across the street, you wont need to change your plan. But its always nice to know if you can change plans.
Working with a licensed Medicare agent can save you time and money, our agents can help you compare all the plan options in your area.
Give us a call now at the number above to see the Medicare plans available in your zip code. Or fill out an online rate form to compare your options.
Are $0 Premium Medicare Advantage Plans Really Free
You might have been searching for Medicare Advantage plans available in your zip code and found a plan with a $0 monthly premium. This plan may appear to be âfreeâ in that you donât have to pay a premium to be covered by the plan. You generally still have to pay your Medicare Part B premium, however.
And the plan may have other costs, too, like copays and/or coinsurance. In fact, plans with lower premiums or $0 premiums may have higher copayments or coinsurance.
Another cost that a $0 premium Medicare Advantage plan might have is an annual deductible. A deductible is an amount that you must pay out-of-pocket before your Medicare Advantage plan begins to pay for your covered services.
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What Is Medicare Part C
Original Medicare is made up of Medicare Part A and Part B . Medicare Part C plans are all-in-one alternative healthcare options to Original Medicare and include the same benefits as Medicare Part A and Part B plus additional coverage.
When you enroll in a Medicare Part C plan, the company you enroll with becomes your primary source of health insurance.
Medicare Part C coverage must at least match Original Medicare coverage. However, since there are several Medicare Part C plan types, costs for enrollees can vary widely.
Applying For A Medicare Part B Give Back Benefit
So, what is the enrollment process for the Give Back benefit? Many people are looking to save as much money as possible when it comes to their health care costs, so they want to know how to get signed up for this program. The process is quite simple, so here is how to do it. First, you need to find a Medicare Advantage plan in your area that offers this benefit. You can use the Medicare plan finder tool at Medicare.gov to help you with this process. You can also speak with a licensed insurance agent in your local area who can help you find the best Medicare Advantage plans in your area to fit your needs.
Once you find an available plan that provides the Medicare coverage you need, you should check the plan details to determine what the plan offers when it comes to the Give Back benefit. You should be able to find this information in the plan details. Take a look at the Evidence of Coverage section or the Summary of Benefits. Search for the Premiums section and look for a Part B Premium Reduction line item. This will give you more information on the premium buy-down as it will tell you how much of your Part B premium the plan will pay.
Medicare Part B Give Back Benefit
The Medicare Part B give back is a benefit specific to some Medicare Advantage plans. This benefit covers up to the entire Medicare Part B premium amount for the policyholder.
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The give back benefit can be a great way for beneficiaries to save, as the premium is deducted from their Social Security checks each month. However, not all Advantage plans offer this benefit.
Plan availability depends on your location as these plans are not available in every ZIP Code. Additionally, youll first want to know if a Medicare Advantage plan will provide the best coverage for your needs.
Defer Income To Avoid A Premium Surcharge
The standard premium for Medicare Part B is $170.10 per month in 2022 but that assumes youre not a higher earner. Those with higher income levels are subject to higher premium costs. For 2022 heres what youre looking at:
|2022 Medicare Part B premium costs by income level|
|Income level: individual tax filer||Income level: joint tax filer||Total monthly premium|
|$750,000 and above||$578.30|
If youre able to defer income strategically to future tax years so that you can report a lower total on your tax return, you might save yourself a higher premium charge for at least a year, since those surcharges are based on previous tax returns. For example, your 2020 tax return will determine whether you pay a surcharge in 2022 .
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Structure Your Income To Avoid A Premium Surcharge
The standard premium for Medicare Part B is $170.10 per month in 2022, and dropping to $164.90/month in 2023. But that assumes youre not a higher earner. Those with higher income levels are subject to higher premium costs. For 2022 heres what youll pay for Part B if your income falls into the level that triggers a surcharge:
|2022 Medicare Part B premium costs by income level|
|Income level: individual tax filer||Income level: joint tax filer||Total monthly premium|
|$750,000 and above||$560.50|
If youre able to defer income strategically to future tax years so that you can report a lower total on your tax return, you might save yourself a higher premium charge for at least a year, since those surcharges are based on previous tax returns. For example, your 2022 tax return will determine whether you pay a surcharge in 2024 .
Who Qualifies For The Medicare Giveback Program
You can qualify for the giveback program if you’re enrolled in Medicare Part A and Part B, are enrolled in a Medicare Advantage plan that provides the benefit, and live within the zip code service area of a plan that offers the program.
It’s important to know that not all plans offer this program, and you must be enrolled in a qualifying plan in order to get the benefit.
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The Hold Harmless Provision Protects You If You Also Receive Social Security Benefits
Seniors who are enrolled in Medicare and Social Security simultaneously have their Part B premiums deducted directly from their Social Security benefits. Doing so isnt just a convenience, though in some cases, it can save you from rising premium costs thanks to Medicares hold-harmless provision.
This provision protects you from losing out on Social Security income when Part B premium increases surpass the cost-of-living adjustments that are applied to benefits each year. This means that if Part B increases by $30 a month in a given year, but your COLA only raises your monthly benefits by $24, you save yourself the extra $6 by not having to pay it.
In recent years, the COLA has been more than adequate to cover the full cost of the standard Part B increases, so the hold harmless provision hasnt been applicable . But its always there, just in case the Part B premium increase is more than a beneficiarys COLA for a given year.
Oasdi Beneficiaries By State And Zip Code 2021
This annual publication focuses on the Social Security beneficiary populationpeople receiving Old-Age, Survivors, and Disability Insurance benefitsat the ZIP Code level. It presents basic program data on the number and type of beneficiaries and the amount of benefits paid in each state, Social Security Administration field office, and ZIP Code. It also shows the number of men and women aged 65 or older receiving benefits. The data include only persons whose benefits are currently payable. Those whose benefits were withheld are excluded.
Cherice Jefferies in the Office of Statistical Analysis and Support programmed and compiled the data for this report. Staff of the Office of Dissemination edited the report and prepared it for web publication.
Natalie T. LuActing Associate Commissioner for Research, Evaluation, and Statistics November 2022
To avoid disclosing the reason for Social Security eligibility of small groups and the amounts of benefits received, a controlled rounding procedure was used for field office and ZIP Code data. Data are not shown for ZIP Codes with fewer than 15 beneficiaries.
Under the controlled rounding procedure, ZIP Code data on the number of beneficiaries shown in the table are changed according to the following formula:
The dollar amounts in the tables are rounded to the nearest thousand.
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What Does Zip Code Have To Do With Medicare
It may come as a surprise the difference in Medicare options by zip code or state. Medicare programs vary depending on where you live.
Medicare is a federal program so benefits are country-wide. But, when it comes to planning options, some areas may offer a plethora of coverage options while other, usually more rural areas, will have fewer options.
Is The Medicare Give Back Benefit The Same As The Medicare Part B Premium Reduction
Part B premium reduction is another term for the give back benefit. Depending on the region where you live, you may see slightly different names for the program.
However, the feature functions the same across plans. No matter what you call it, the give back benefit, or Medicare Part B Premium Reduction is put in place to save policyholders money on their health care costs.
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Why Are Healthcare Premiums Set By County
Healthcare premiums are typically set by county to account for a few different geographic factors: The general cost of doing business in an area. Rent as well as wages are higher in urban areas than rural areas, for example, which necessitates higher payments to providers to allow them to operate at a profit.
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What Are Medicare Advantage Part B Buy Back Plans
Medicare Advantage plans are additions to your existing Medicare coverage. They can vary greatly in coverage amounts and premium prices. Some Medicare Advantage plans can come with a $0 premium or a low premium in addition to a Part B buy back .
If you pay your Part B premium automatically out of your Social Security check, this could feel like a bonus added to your monthly checks! Youll start seeing a bit more coming in, which is nice, assuming the plan you choose has the buy back option.
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Sign Up For Part B On Time
Your initial window to enroll in Medicare begins three months before the month of your 65th birthday, and ends three months after that month. If you dont sign up during that seven-month period, you can enroll during Medicares General Enrollment Period each year.
But for each 12-month period you go without Medicare coverage despite being eligible, youll be hit with a penalty that raises your Part B premium cost by 10%. Worse yet, that penalty will remain in effect for the rest of your life. The takeaway? If you want to save money, dont be late.
Is There A Way To Get Free Medicare Coverage
If youâre a low-income person eligible for Medicare, you also may be eligible for Medicaid. Being eligible for both Medicare and Medicaid is called being âdual eligible.â In some cases, Medicaid might pay your Medicare Part B monthly premium. Medicaid may also offer additional benefits that traditional Medicare doesnât, such as prescription drug coverage.
Are you looking for a Medicare Advantage plan with a $0 premium? To see if one is available in your area, just enter your zip code on this page.
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What Types Of Medicare Advantage Plans Are There
Coordinated care plans
Most Medicare Advantage plans are coordinated care plans. Coordinated care plans have a network of providers. If you use the plan’s network of providers, you generally pay less out-of-pocket for care.
Health Maintenance Organization plans
HMO plans use a network primary care provider to help coordinate care. HMO plans usually only pay for providers in the plan network.
Point of Service plans
POS plans have the benefits of an HMO plan, but with more flexible provider choices. Costs are generally lower if you use the plan’s network providers.
Preferred Provider Organization plans
PPO plans cover providers both in and out of network. These plans pay a portion of the cost for using an out-of-network provider.
Special Needs Plans
Special Needs Plans have benefits that cover special health care or financial needs. All SNPs include prescription drug coverage.
- Dual-Eligible Special Needs Plans for people who have both Medicare and Medicaid
- Chronic Special Needs Plans for people living with severe or disabling chronic conditions
- Institutional Special Needs Plans for people who live in a skilled nursing facility
- Institutional-Equivalent Special Needs Plans for people who live in a contracted assisted living facility and need the same kind of care as those who live in a skilled nursing facility
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