Are There Any Concerns With The Part B Give Back
Weve been helping our clients understand their Medicare choices for over two decades. One plan does not fit all. The mistake consumers sometimes make is enrolling in a plan based on cost only. The benefits and network availability must also be considered.
While its tempting to choose a plan with a large giveback benefit, it might be unsuitable if your doctors or hospitals are not in their network. And you should also make certain any Advantage plan covers your most important prescriptions. Especially if you take anything expensive or on a higher Tier.
Also, you want to be sure youre comfortable with Medicare Advantage plans in general. Some people prefer the flexibility of a Medicare Supplement. And switching back and forth between the two is not guaranteed. There are many variables to consider when choosing a supplemental policy.
Medicare Give Back Benefit What Is It And How Does It Work
So you keep hearing about something called the Give Back Benefit. Its all over the TV commercials and print ads. So whats with all the hype?
The Give Back benefit is used to reduce the cost of the Medicare Part B for individuals. Its an amount that is credited to your Part B monthly premium payment.
This benefit is provided through insurance companies that offer Medicare Advantage Plans. The insurance company will notify Medicare and Social Security that they will cover a portion of your Part B premium.
How Much Money Can I Get Back From A Give Back Benefit
This depends on the Medicare Advantage plan you choose, and how much of a give back benefit it offers. Give back benefits can cover up to $170.10 per month in 2022, which is the full Part B monthly premium for most people. However, many plans offer less than the full Part B premium. You may be able to select a plan that offers $50 or $100 back each month. If so, youll pay the remaining amount each month out of your Social Security check. For example, if you receive a monthly $100 give back benefit, the $70.10 difference will be deducted from your Social Security check each month.
Don’t Miss: List Of Employee Benefits And Perks
How Do You Get Medicare Money Back
You dont get Medicare money back in the traditional sense with a Medicare Part B Give Back plan.
The carrier doesnt send direct payments to beneficiaries. Instead, you pay less for your premium. The way this works depends on the way you make your Medicare payments. To illustrate:
- Premiums deducted from Social Security checks: Youll notice the rebate added to your monthly Social Security check. The Social Security Administration usually takes between 1 to 3 months to process your paperwork and apply your refund.
- Alternative payment method: If you use a different payment method, such as direct debit, you only need to pay your part of the Medicare Part B premium if the plan doesnt cover it entirely.
How We Help Our Clients
We look at these Part B rebate plans for our clients who spend several months per year outside their home market and buy their drugs elsewhere typically outside the US. Even this has a potential penalty in the future which must be carefully considered against total beneficiary cost and risk in the future. Because there is no free lunch. As an example, we represent 29 different Part B plans here in Nashville, of which 4 have Part B rebates. We were busy this last selling season but did not find that these giveback plans were a good fit for any of our customers when weighed against the needs of the client and the benefits of all the available plans.
The takeaway message here is this Medicare Advantage plans can be great for certain clients, but any individual benefit of a plan must be considered against the medical needs of the beneficiary, the expected total cost of care in the benefit period, and the risks that the client should reasonably accept. Focusing on any single plan benefit is misleading at best and can cause real damage to beneficiaries.
Sorry, but there is no Medicare Santa.
Tags:
Don’t Miss: Social Security Apply Online Retirement Benefits
Are All Medicare Plans Eligible
Individuals who pay their own Medicare Part B premium can be eligible for the Part B buy down. Those with Medicaid or other forms of assistance that generally pay the Part B premium cannot enroll in one of these plans. Persons with Medicare Supplement or Medigap coverage are not eligible for the Give Back Benefit.
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, its important to do your research and compare plans, benefits, and costs to ensure youre making the best decision for you.
Recommended Reading: Anthem Medicare Over The Counter Benefits
What Are Medicare Part B Give Back Plans
- Read about Medicare Advantage Part B Give Back plans and their benefits. Find out if these flexible plans could save you money on the health services you need.
Medicare Part B Give Back plans are special Medicare Advantage plans that return some or all Part B premiums to beneficiaries.
These plans are sometimes called Medicare Buy Back plans or Medicare premium reduction plans. Securing one of these Medicare Advantage plans is a great way to put more money in your pocket each month.
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.
Read Also: Unemployment Benefits On Tax Return
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.
What Factors Other Than Premium Should I Consider When Choosing A Medicare Advantage Plan
The total monthly premium is just one aspect of your coverage, and there are numerous other features that youre going to want to take into consideration when youre making a plan selection. For example:
- How will the plan cover your specific prescription drugs, and what pharmacies are in-network?
- Which doctors and hospitals are in the plans provider network?
- What are the total out-of-pocket costs that youre likely to have under the plan?
- What additional benefits does the plan provide, and how much value will you get from them? This can include coverage for things like over-the-counter drugs, in-home support, dental services , hearing aids, gym memberships, and more. Particularly for people with certain chronic medical conditions, Medicare Advantage plans are increasingly offering additional supplemental benefits, but you have to qualify for these based on your medical needs.
- What star rating does the plan have?
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.
Recommended Reading: Social Security Widows Benefits Calculator
Avoid Overlooking These Details
When it comes to the monthly cost of Medicare, premiums are top of mind for most. Whether you go to the doctor or not, you have to pay your premiums, which is why a premium reduction can be tempting. Below are questions you should ask to avoid the Give Back Benefit costing you something you cant afford to lose:
-
Are your preferred doctors in-network?
-
Are your prescription drugs covered?
-
What is the difference in copay amounts?
-
Are the services you need covered?
-
What is the annual out of pocket maximum?
Despite limitations and drawbacks present in plans with a give back program, the benefit has risen in popularity in the past few years.
Is The Give Back Program New
Thanks to a deluge of television ads, this may be the first time youve heard of the opportunity. But, its actually been around for years .
There are some 3,500 different Medicare Advantage plans available nationwide. No accurate numbers reflect how many offer the benefit. But experts note that the number could be around 500 to 600. Keep in mind however, that for some plans the bonus can be as little as $0.10 a month. For others it can be the maximum for 2022.
Also Check: Deceased Retired Military Spouse Benefits
Are Medicare Part B Give Back Plans Cheaper Than Other Medicare Plans
Since providers waive all or part of the Part B premium, they may be cheaper than other Medicare Advantage plans.
However, compared to Original Medicare combined with a Medigap Medicare Supplement plan, you may find that Medicare Part B Give Back plans have higher cost-sharing. Co-payments, co-insurance and deductibles for doctors visits and health services, particularly out-of-network, may cost you more than Part B premiums with Original Medicare plus a Medicare Supplement plan.
Consider also that High Deductible plans, with lower premiums than standard Medicare Advantage plans, may be more affordable than Medicare Part B Give Back plans for people who rarely make claims.
Research all your options to determine whether a Medicare Part B Give Back plan will be more affordable for you in the long run than another Medicare plan.
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.
Also Check: Social Security Benefit Formula 2021
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.
Where Is The Part B Giveback Offered
The commercials for Medicare Advantage giveback rebates are aired nationwide, but plans that offer this benefit are not available in all areas. And even if youre in an area where this benefit is offered by at least one Advantage plan, its likely that the majority of the available plans will not offer it.
Assuming there are Medicare Advantage plans in your area that offer a giveback rebate, its important to evaluate all of the available plans based on how theyll serve your overall needs. If a plan has a $50 giveback rebate but will end up costing you an extra $60 every month at the pharmacy, or doesnt include your doctors in its network, its probably not going to be your best option.
Don’t Miss: Office Depot Employee Benefits Website
How Much Can My Medicare Premiums Decrease
If you qualify and there are plans available in your area, you will see monthly Part B Giveback amounts range from $0.10 up to the maximum yearly standard premium.
This benefit is designed to work with Social Security. Your premium reduction is reflected in your Social Security check each month. In other words, your check will increase by the amount the giveback benefit decreases your premium.
Typically, plans do not pay you directly. If you defer Social Security, then you would see the credit amount applied to what you owe the government. Your monthly or quarterly premiums owed to government are simply reduced by the amount that applies to your chosen Advantage plan.
The give back benefit does not reduce IRMAA charges, unfortunately. Those with higher incomes can only have their premiums reduced by the same amounts listed above so $148.50 is the maximum amount available this year.
Give Back Eligibility And Medicare
If youre eligible for Medicare and you have Part B medical insurance, then theres a cost for Part B, and the cost for Part B can change every year.
For most people on Medicare, the Part B premium is either deducted from your Social Security benefit every month or you pay it another way such as through your bank account.
If you enroll in a Medicare Advantage Plan that offers a Give Back benefit, then you will see a reduction in your Part B monthly premium.
This will be for every month that youre enrolled in that plan. The plans can change every year, so you need to be aware that the Give Back benefit could change as well.
Recommended Reading: Always Best Care Employee Benefits
How Can The Service Vary
Medicare can be broken down into two different plans: Medigap and Medicare Advantage.
Medigap, often known as Medicare Supplement, is available to Original Medicare beneficiaries, and it covers the ‘gap’ between what the original service pays and what you owe in extra expenses.
Medigap plans are run by private insurance companies and therefore their availability and pricing will vary depending on location. You can compare the different plans available in your region using the official U.S. government website.
Medicare Advantage, on the other hand, takes the place of Original Medicare and is a more reinforced package, offering several different plans.
Is Medicare Different In Each State
Before we begin our discussion of Medicare coverage by state, letâs consider basic eligibility for Medicare. The Centers for Medicare & Medicaid Services reports that the following factors make you eligible for Medicare:
- Age. If you are 65 or older, you qualify.
- Disability. If you get disability income from Social Security or the Railroad Retirement Board , you’ll gain eligibility for Medicare once you’ve recieved your Social Security or RRB disbursements for 24 months. There are also special qualifying criteria for those with Lou Gehrig’s disease and end-stage renal disease which can eliminate waiting periods.
Assuming now that you are eligible, letâs address the questionâis Medicare different in each state? Since Original Medicare is a completely federal program, itâs equally available to residents in all U.S. states.
However, certain programs within Medicare vary from state to state in terms of rules, availability, and pricing. Two such Medicare plans are Medigap and Medicare Advantage. The coverage and features of these Medicare plans will vary depending on where you live.
Medigap
Medigap, sometimes called Medicare Supplement, is available to Original Medicare beneficiaries. It works like an insurance policy to cover the âgapâ between what Original Medicare pays and what you owe in out-of-pocket expenses .
Medicare Advantage
Don’t Miss: How Do You Qualify For Extra Medicare Benefits
Check Online For Free At Medicaregov
The Medicare website lists the general qualifications to get and verify Medicare coverage. It also has resources to determine the applicants eligibility for Medicare.
Medicare has an online eligibility tool to determine status for benefits and can tell you the insurance premium for Medicare Part A, if you have to pay anything for it.
Read Also: Chapter 7 Medicare Benefit Policy Manual
Got Questions About The Medicare Giveback Benefit Here Are Some Answers
Can you really get a Medicare giveback from a Medicare Advantage plan?
getty
A friend forwarded me an ad he saw online. The headline read, Seniors over 65 are getting huge benefits this year. See if you qualify for $144 a month. How can I get this? he wondered.
Another friend asked whether I saw the commercials for the Medicare giveback benefit of up to $144. How could I miss them? I replied.
Lets tackle some questions about the Medicare giveback benefit.
What is the giveback benefit?
The giveback benefit is officially the Part B premium reduction.
This benefit is making a big splash this year, but it first appeared in 2003. A Federal regulation allowed Medicare+Choice plans to receive a reduction in its payments, which in turn helps to fund the giveback.
How do I qualify for the giveback?
The first time I heard about this offer, I wondered whether there might be income-related criteria. In other words, did the persons income have to be below a certain level? But that is not the case. To qualify for a premium reduction, you must:
- Be a Medicare beneficiary enrolled in Part A and Part B,
- Be responsible for paying the Part B premium, and
- Live in a service area of a plan that has chosen to participate in this program.
How many plans provide this benefit?
Thats a good question. You qualify once you enroll in a plan but there are not that many plans participating.
Can I get the premium reduction with other benefits?
Does the plan send me a check?
Any words of wisdom?
You May Like: State Of Alabama Employee Benefits