Do you have to pay for medicare part b if you have an advantage plan

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There are four parts of Medicare: Part A, Part B, Part C, and Part D.

  • Part A provides inpatient/hospital coverage.
  • Part B provides outpatient/medical coverage.
  • Part C offers an alternate way to receive your Medicare benefits (see below for more information).
  • Part D provides prescription drug coverage.

Generally, the different parts of Medicare help cover specific services. Most beneficiaries choose to receive their Part A and B benefits through Original Medicare, the traditional fee-for-service program offered directly through the federal government. It is sometimes called Traditional Medicare or Fee-for-Service (FFS) Medicare. Under Original Medicare, the government pays directly for the health care services you receive. You can see any doctor and hospital that takes Medicare (and most do) anywhere in the country.

In Original Medicare:

  • You go directly to the doctor or hospital when you need care. You do not need to get prior permission/authorization from Medicare or your primary care doctor.
  • You are responsible for a monthly premium for Part B. Some also pay a premium for Part A.
  • You typically pay a coinsurance for each service you receive.
  • There are limits on the amounts that doctors and hospitals can charge for your care.

If you want prescription drug coverage with Original Medicare, in most cases you will need to actively choose and join a stand-alone Medicare private drug plan (PDP).

Note: There are a number of government programs that may help reduce your health care and prescription drug costs if you meet the eligibility requirements.

Unless you choose otherwise, you will have Original Medicare. Instead of Original Medicare, you can decide to get your Medicare benefits from a Medicare Advantage Plan, also called Part C or Medicare private health plan. Remember, you still have Medicare if you enroll in a Medicare Advantage Plan. This means that you must still pay your monthly Part B premium (and your Part A premium, if you have one). Each Medicare Advantage Plan must provide all Part A and Part B services covered by Original Medicare, but they can do so with different rules, costs, and restrictions that can affect how and when you receive care.

It is important to understand your Medicare coverage choices and to pick your coverage carefully. How you choose to get your benefits and who you get them from can affect your out-of-pocket costs and where you can get your care. For instance, in Original Medicare, you are covered to go to nearly all doctors and hospitals in the country. On the other hand, Medicare Advantage Plans typically have network restrictions, meaning that you will likely be more limited in your choice of doctors and hospitals. However, Medicare Advantage Plans can also provide additional benefits that Original Medicare does not cover, such as routine vision or dental care.

If you’ve heard about the Medicare Part B Giveback Benefit, you may have questions about how it works.

Here’s a look at what it is, who’s eligible and more.

What is the Medicare Part B Giveback Benefit?

The Medicare Giveback Benefit is a Part B premium reduction offered by some Medicare Part C (Medicare Advantage) plans.

If you enroll in a Medicare Advantage plan with this benefit, the plan carrier will pay some or all of your Part B monthly premium. The amount covered can range from 10 cents to the full Part B premium cost ($164.90 in 2023).

Who’s eligible for a Medicare Advantage plan with a Part B Giveback Benefit?

To be eligible, you must:

  • Be enrolled Original Medicare (Parts A and B)
  • Pay your own Part B premium

You are not eligible if you receive Medicaid or any government assistance that helps you pay your Part B premium. Also, the Part B Giveback is restricted to certain states and counties. Plans may not be available in your area.

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:

  1. If you pay your Part B premium through Social Security, the Part B Giveback will be credited monthly to your Social Security check.
  2. If you don’t pay your Part B premium through Social Security, you’ll pay a reduced monthly amount directly to Medicare.

Is the Medicare Giveback Benefit a type of Medicare Savings Program?

No. The Medicare Giveback Benefit is only available to people enrolled in certain Medicare Advantage plans. Medicare Savings Programs (MSPs) are available to people enrolled in Original Medicare who have limited income and resources.

To learn more about MSPs, including how to apply, read this article on Medicare Savings Programs.

Learn more about Medicare

For more helpful information on Medicare, check out these 10 frequently asked questions about Medicare plans.

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Do I pay Part B if I have an advantage plan?

If you join a Medicare Advantage Plan you'll still have Medicare, but you'll get most of your Part A and Part B coverage from your Medicare Advantage Plan, not Original Medicare. You must use the card from your Medicare Advantage Plan to get your Medicare- covered services.

Do you still have to pay Medicare B premium with Medicare Advantage?

In addition to your Part B premium, you usually pay a monthly premium for the Medicare Advantage Plan. In 2022, the standard Part B premium amount is $170.10 ($164.90 in 2023) (or higher depending on your income).

What are the disadvantages to a Medicare Advantage Plan?

Medicare Advantage can become expensive if you're sick, due to uncovered copays. Additionally, a plan may offer only a limited network of doctors, which can interfere with a patient's choice. It's not easy to change to another plan. If you decide to switch to a Medigap policy, there often are lifetime penalties.

Does Medicare Advantage pay for everything?

Medicare Advantage Plans must cover all of the services that Original Medicare covers except hospice care.