Medicare Zero-Dollar ($0) Premium Plans

Jun 15th, 2017     Medicare

Medicare Advantage Plans are offered by private companies which are approved by the Medicare. They offer, at minimum the same coverage of Original Medicare (Part A & Part B), however in MA plans, members can visit doctors in the plan’s network only (or pay higher co-pay) which help the insurance companies in saving some costs. These savings can be passed on to the members through lower (or $0) premiums and some additional benefits. These kind of plans which do not charge any additional premium (apart from the part-B premium) are called $0 premium medicare advantage plans. These plans could also include additional benefits such as foreign travel emergency care, preventive dental services, routine vision care and fitness benefits.

Who can enroll for $0 premium medicare advantage plan?

  • People who have Medicare Part A and Part B coverage.
  • People who come from the service area of the plan.
  • People who do not suffer form End-stage Renal disease.

How to enroll for $0 premium medicare advantage plan?

  • Visit the plan’s website for any online registration.
  • Contact the plan for offline mode of registration.
  • Search for the contact details of the plan to get enrolled.
  • Use Medicare’s plan finder from the official website
  • Call at 1-800-MEDICARE (1-800-633-4227).

What is the cost of $0 premium medicare advantage plan?

As the name suggests, $0 premium plans comes without any additional cost (you just have to pay your Part B premium). Just like most medicare advantage plans, $0 premium plans also use a combination of deductibles, co‑insurance and co‑payments to share the costs of care with the member. Deductibles, co-pays and co-insurance, plus all costs for ‘services that aren’t covered’ are called “out-of-pocket costs”.

Other costs associated with $0 premium plans

$0 premium Medicare Advantage plans include out-of-pockets costs such as annual deductibles, co-payments, and coinsurance. For example, most of the Medicare Advantage plans have primary and specialist fee co-payments for the services offered. Apart from that, members can visit doctors within the plan’s network and may also need to get a referral for seeing the specialist (based on the plan’s terms of coverage).

Medicare Advantage plans include maximum out-of-pocket limit to control costs. This is a cap on the amount that the patient pays for the covered medical expenses in a calendar year. However, the patient must continue to pay his monthly Part B premium when enrolled in a Medicare Advantage plan.

  • Original Medicare contracts with Medicare Advantage plans to have private insurance companies cover a member’s Medicare bills. The beneficiary of this plan no longer associates with original medicare.
  • Medicare Advantage plans receive a monthly fee from the government to cover the members’ health-care bills. This amount can change based on age, sex, and health.
  • Medicare Advantage insurance companies associate with a network of doctors, hospitals, and other health providers with a smaller fee rate. This can produce savings, which can, in turn, be passed onto the beneficiary through extra benefits not covered by Original Medicare.
  • Medicare Advantage members must continue to pay for Part B premium.

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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.