Making decisions around healthcare can be complicated, so understanding your coverage is essential. One perk you might not know about is the Medicare Giveback Benefit.
The Medicare Giveback Benefit is an extra perk available with Medicare Advantage plans. If you qualify, your plan provider may cover some or all of your Medicare Part B premiums.
Keep reading to understand the Medicare Giveback Benefit, which parts of Medicare it affects, who it helps, and what you need to know before changing your Medicare Coverage to take advantage of the giveback.
What is the Medicare Giveback Benefit?
A giveback, similar to a rebate, essentially puts money back in your wallet each month. In this instance, the benefit is generally referred to as a “Medicare Part B giveback” or “Part B Premium reduction.”
The Medicare Giveback Benefit is a provision within certain Medicare Advantage (Part C) plans. These plans offer beneficiaries additional benefits or reduced out-of-pocket costs beyond what Original Medicare provides, which may include coverage for prescription drugs, dental care, vision care, hearing aids, fitness programs, and more.
If you enroll in a Medicare Advantage plan that offers this benefit, the plan carrier will pay some or all of your Part B monthly premium. Depending on your circumstances, the amount covered can extend from just a few cents to $100 of the total Medicare Part B monthly premium cost — for 2024, that’s $174.70 a month.
But remember, the Part B premium reduction benefit is only offered by some Medicare Advantage plans, not all.
Who is eligible for the Medicare Giveback Benefit?
The Medicare Giveback Benefit could help to lower your Part B premiums, though not everyone is eligible. Not all Medicare Advantage plans include this benefit, so you’ll need to carefully review plan details during the annual enrollment period to determine if the Medicare Advantage plan you’re considering offers extra benefits beyond Original Medicare.
If your plan does offer the Medicare Giveback Benefit, you may be eligible if:
- You are enrolled in a Medicare Advantage plan that offers the Plan B reimbursement benefit
- You pay your Part B premiums directly from your Social Security benefits
- You live in an area where the giveback benefit is provided
That last part is important: While many major insurers working with Medicare offer the Giveback benefit, its availability in your service area depends on your provider’s coverage policies. You’ll want to call your current Medicare Advantage plan provider to ask if giveback benefits are available where you live.
Background on Original Medicare vs Medicare Advantage
When you enroll in Medicare for the first time or change your plan during the fall open enrollment period, you’ll be able to choose from two options:
- Original Medicare offers hospital insurance through Part A and medical insurance through Part B. When you need care, you pay a deductible and coinsurance, while Medicare pays for its share of approved costs. Prescription Drug Coverage (Medicare Part D) is not a component of Original Medicare.
- Medicare Advantage plans cover you through a private company that’s approved to offer Medicare. Medicare Advantage plans include Parts A and B coverage, and some of Part D prescription drug coverage is also included.
Only Medicare Advantage plans qualify for the Medicare Giveback Benefit. If you’re interested in taking advantage of this benefit but are currently enrolled in Original Medicare, you’d need to change your plan to Medicare Advantage during open enrollment.
How does the Medicare Giveback Benefit work?
Medicare Advantage plans with the premium reduction benefit function just like other Medicare Advantage plans. The only change is that your monthly Part B premium is trimmed by your plan’s giveback amount.
For instance, if you sign up for a Medicare Advantage plan with a $100 giveback amount, your 2024 Part B premium will drop to just $74.70. This benefit works hand in hand with Social Security, automatically applying the premium reduction. Simply put, you’ll notice the giveback amount as a credit on your monthly Social Security statement, and your monthly Social Security benefits will increase by that same amount.
However, if your Medicare Advantage plan premiums are paid by personal check each month, you won’t receive a rebate check from your insurance company for the Plan B premium reduction. Instead, the insurer managing the Medicare Advantage plan coordinates directly with Medicare and Social Security and, as a result, your Part B premium statement will show the giveback amount as a credit.
Consider this before switching Medicare Advantage plans just to get the Giveback Benefit
Whether or not a plan offers a Medicare Giveback Benefit should not be the only thing you consider when evaluating whether or not to switch to a Medicare Advantage plan. First of all, not every Medicare Advantage plan has a Medicare Part B premium reduction. And even if they do, they might not have all the other coverages and services you need.
For example, a Medicare Advantage plan in your area might give you a discount on your Part B premium, but it might not cover things like prescription drugs, eyeglasses, dental care, or hearing aids. If those aspects are important to you, the extra monthly costs for those other things can cancel out the benefit of paying less for Part B.
It’s also important to consider the overall costs; a plan with a dollar or less of a giveback may not be worth it. Even with a $100 giveback, you need to look at the entire plan. Ensure that the $100 savings justifies the long-term out-of-pocket costs.
Generally, plans with a giveback feature higher copays, maximum out-of-pocket expenses, and fewer additional benefits compared to the non-giveback option from the same company. Bypassing the giveback might end up being cheaper over the whole year.
How to make the most of the Medicare Giveback Benefit
To maximize the benefits of the Giveback Benefit, Medicare beneficiaries should follow these steps:
- Explore Medicare Advantage Plans: Look into different Medicare Advantage plans in your area to see which ones offer the extra benefits you really want.
- Check Plan Details: Read the plan’s Summary of Benefits to see exactly what the Medicare Giveback Benefit includes and if there are any extra costs.
- Think About Your Health Needs: Consider what healthcare services you need now and in the future to make sure the plan you pick covers everything you need.
- Keep Up to Date: Stay informed about any changes to your Medicare Advantage plan’s benefits so you can make smart choices about your healthcare coverage.
Helping you make an informed decision
If you’re enrolling in Medicare for the first time, it may help to talk to a Guided Solutions Medicare expert about your options. Our advisors can point out the differences between Original Medicare and Medicare Advantage plans and — taking into account the Part B Premium reduction, if available — help you decide which one might be right for you.
Picking the right Medicare Advantage plan can be a big deal. If you’ve got questions or need help, don’t hesitate to reach out to the experts at Guided Solutions. We are here to give you the info and support you need when it comes to all things Medicare.