Is Medicare Advantage Free? A Guide to No-Premium Plans
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Is Medicare Advantage free? Sort of. In 2023, 66% of Medicare Advantage plans have no monthly premium, according to KFF, a health policy nonprofit. That means members pay $0 for the plan.
Medicare Advantage plans are a bundled alternative to Original Medicare. They include Medicare Part A (hospital insurance), Part B (medical insurance) and usually Part D (prescription drugs). They also usually offer additional benefits that aren’t covered under Original Medicare, such as some dental or vision coverage.
Free Medicare Advantage plans
One of the Medicare Advantage plan costs is a monthly premium. For the majority of Medicare Advantage plans, that premium is $0, which means you owe nothing each month. You do, however, still have to pay your Medicare Part B premium, which is $164.90 per month in 2023.
Other Medicare Advantage costs
Free Medicare Advantage plans aren’t actually fully free unless you never seek medical care. Depending on your plan, you may have to pay deductibles, coinsurance or copays when you see a doctor or fill a prescription.
Deductible. This is an amount you pay out of pocket before your Medicare Advantage plan starts to pay for covered services.
Coinsurance. This is a percentage you may have to pay for medical costs, generally after you hit your annual deductible. For instance, you may owe 20% of the cost of a doctor’s visit after you reach your deductible.
Copayment. This is a flat fee you may have to pay for a medical service or drug. For instance, you may have to pay $15 every time you see your primary care physician.
Medicare Advantage plans have an out-of-pocket maximum, which means there’s a cap on the amount you can spend each year. The maximum out-of-pocket limit allowed is $8,300 in 2023, but some plans have lower limits.
How to choose a free Medicare Advantage plan
You can use Medicare’s plan comparison tool to search for Medicare Advantage plans. Once you enter your ZIP code and answer a few questions, you can get prices for plans available to you. Although many plans show a $0 premium, it’s important to understand the other costs you’ll pay if you need care. (Click “Plan Details” for more information.)
Here are other questions to consider:
Are your doctors in-network? Many Medicare Advantage plans require you to get care from medical providers and hospitals in their network.
Are your prescriptions covered? Prescription coverage can change from year to year, so check a plan’s coverage each year during Medicare open enrollment.
What other benefits are available? Does the plan offer dental or hearing coverage? How much?
You may find that two $0-premium plans are very different, so make sure you’ve done some comparisons before you sign up.
How to enroll in a Medicare Advantage plan
There are a few periods when you can sign up for a Medicare Advantage plan:
Initial enrollment period: This is your first chance to enroll in Medicare and generally includes your 65th birthday month plus the three months before and after it.
General enrollment period: If you miss your initial enrollment period, you can sign up for Original Medicare or Medicare Advantage from Jan. 1 to March 31 each year. Your coverage will start the month after you sign up, and you may owe late penalties.
Special enrollment period: You may qualify for a special enrollment period if certain situations apply, such as moving out of your plan’s service area or losing your employer group health coverage.
Once you’ve signed up for a Medicare Advantage plan, you can switch plans during Medicare open enrollment from Oct. 15 to Dec. 7 each year. You can also switch during Medicare Advantage open enrollment from Jan. 1 to March 31 each year, but only if you already have a Medicare Advantage plan. Special enrollment periods continue to apply if any of the relevant situations happen to you.