The True Cost of $0-premium Medicare Advantage Plans

  • Originally published February 16, 2011 , last updated December 29, 2015
The True Cost of $0-premium Medicare Advantage Plans

You may be faced with prospects who are considering Medicare Advantage plans that provide Medicare-covered benefits for little or no initial premiums. $0 premium may sound attractive on the surface, but in reality these plans have out-of-pocket expenses many people don't plan for.

The best way to handle this situation is to educate yourself beforehand so you can present the facts to your prospects and help them make the best choice for their circumstances.

Here's what you can do:

1. Understand Medicare Advantage plans.
Medicare pays Medicare Advantage plans to provide Medicare-covered benefits instead of Medicare providing them. Types of plans include:

  • Managed Care Plans (HMOs)
  • Preferred Provider Organizations (PPOs)
  • Private Fee-for-Service plans (PFFS)

Depending on the type of plan, enrollees pay deductibles, co-payments and additional premiums for some benefits and/or services.

2. Find out which Medicare Advantage plan is in the community.
For the options in your ZIP codes, visit www.Medicare.gov, scroll to "Search Tools"® select "Compare health plan options in your area." Get the facts about the plan's benefits, premiums and costs for non-covered amounts, deductibles, etc. The "out-of-pocket costs" tab is especially helpful.

3. Know the differences and similarities between plans.
Compare Medicare Supplement and Medicare Advantage Plans. Encourage your clients to look closely before they decide what's best for them. In addition to costs, deciding factors include benefits, hospital and doctor choices, convenience, stability and quality. In many cases, a Mutual of Omaha Medicare supplement and Medicare is the appropriate solution.