The standard monthly premium for Part B Medicare in 2021 is $148.50.
However, with the Part B Give Back Benefit, it may be possible for some people to pay less than the full amount for Medicare coverage.
Read on to see if you're eligible.
Many people are already aware of what Medicare is and how it works. If you fall into that category, then skip ahead to the next section.
However, if you don't understand the basics of Medicare, here's a high-level overview of how it works.
Medicare is a federal health insurance program administered by the Centers for Medicare & Medicaid Services. People 65 and older and some younger people with qualifying disabilities such as End-Stage Renal Disease and ALS are eligible for benefits.
There are four parts to Medicare.There are no premium costs for Medicare Part A in most cases, but you will be responsible for paying deductibles and co-payments as services are rendered. You'll have to pay a monthly premium for all other parts of Medicare.
Some carriers offer a monthly Part B premium reduction to increase plan affordability, making Medicare Advantage plan enrollment even more attractive to potential beneficiaries.
The Part B premium reduction is the net amount a beneficiary pays for their policy. It's been in place since 2003 but has gained a lot more attention in recent years as people try to more closely manage their healthcare costs.
Although it applies to Part B premiums, the Give Back Benefit is actually offered in some Part C Medicare Advantage plans.
When you enroll in a Medicare Advantage plan, your carrier might offer to pay all or part of the premium for your outpatient coverage. As you research Medicare Advantage plans, check the Summary of Benefits or Evidence of Coverage and look for a Part B premium buy-down reference to see if the policy offers this as a benefit.
You can determine how much of a reduction you'll receive in the Summary of Benefits, or you can call your plan's customer service number and they can tell you about the Give Back Benefit as well.
When you sign up for a Medicare Advantage plan with the Give Back Benefit, your insurer will notify the Centers for Medicare & Medicaid Services (CMS) and Social Security Administration (SSA) of the agreement to take on some or all your Part B premium.
Assuming that you are a Medicare beneficiary already enrolled in or eligible for Part A and Part B, there are two primary factors that determine eligibility.
The first has to do with location. Although plans that include this benefit are common, not every Medicare advantage plan offers the Give Back Benefit in every service area. Currently, most ZIP codes have at least one plan that offers this benefit.
The other eligibility factor has to do with how you currently pay for your Medicare Part B premium. To qualify for the Give Back Benefit, you must be able to demonstrate that you are paying for your Part B premium on your own.
If you get financial assistance from state Medicaid or programs such as Medicare Savings Plans, you're not eligible. The logic here is that you're not eligible because you're already receiving financial assistance, and you may not need additional help.
When shopping for a Medicare Advantage health plan, be sure to do your homework in these two areas to ensure that you qualify.
The amount you get back ranges from $10 or less in some counties up to the full Part B premium amount of $148.50. In most cases, it falls somewhere between $20 and $100.
The exact amount you get back depends on plan options in your area. Don't be surprised if you find out that the same plan has different premium reduction amounts in different counties and states.
The other thing that could impact how much you get back is that Medicare Advantage plans individually set fees for premiums, deductibles, and services. Although plan providers must follow Medicare's rules for coverage, they can change the fees associated with their plans once each year. These changes go into effect annually on January 1.
The plan carrier only makes payments to the Social Security Administration. No direct payments are made to the Medicare beneficiary.
The Give Back Benefit appears on your Social Security check or as a credit on your Medicare Part B Premium Statement.
It may take up to 90 days for an initial refund to appear on your Social Security check or your Part B statement. However, once the benefit has been set up, you don't need to do anything more. The dividend is automatically credited.
For 2021 the give back plans in NJ include:
Inquiries can be directed to 800-435-4765
Information is for educational purposes only and should not be construed as an offer of insurance, advice, or recommendation. The information provided is not intended as tax, financial, investment or legal advice. Please consult legal or tax professionals for specific information regarding your individual situation.
Not connected or endorsed by the US Govt or the Federal Medicare Program. Medi-Solutions Insurance Agency, LLC is an independent Life, Accident and Health Insurance Agency, NJ Ref#1642311. Some plans and features may not be available in all states.