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.
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”.
$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.