Why the Medicare Giveback Benefit May Not Be Worth It for You

The Medicare giveback benefit, or Part B premium reduction plan, is becoming more available and popular among beneficiaries. Not an official Medicare program, this benefit is offered by some Medicare Advantage (Part C) plans and covers some or all of your Part B monthly premium.

You may qualify for a premium reduction if you’re enrolled in Part A and Part B, do not rely on government or other assistance for your Part B premium, and live in the service area of a plan that offers this program.

While it may seem enticing to have your Part B monthly premium reduced or eliminated, there are several downsides to the giveback benefit that may not be worth it. Here is some more information about premium reduction plans and things you should consider before enrolling.

Downsides to the Part B premium reduction plan

  • Not always available. Premium reduction plans are only offered by some – not all – Medicare Advantage plans. To enroll in a Medicare Advantage plan, you must live within the service area it serves. This means you may have a limited number of plans in your area, and the reduction program may not be offered by those plans.
  • Possible reduction in benefits. Many beneficiaries enroll in a Medicare Advantage plan because it covers everything Original Medicare does and more, often including coverage for routine vision, dental, hearing and prescription drugs. However, many plans that offer a reduction program eliminate those additional benefits to make up for reducing the Part B premium. The plan’s deductible or other copays/coinsurance may add up to more than the giveback benefit depending on the care you need.
  • Givebacks vary. You may not receive all $148.50 with this program. The amount you get back could range from less than $1 to the full premium amount, which means you still could be required to pay the majority of the premium.
  • You don’t get paid. You’re not reimbursed or sent a check if you qualify for this program. Instead, you’d just pay the reduced premium amount. Your Part B premium comes out of your Social Security check, and your payment would reflect the reduced amount.

For example, if you typically pay $148.50 per month, but your Medicare Advantage plan’s giveback is $50, you don’t get $50 back each month. Instead, you’d only pay $98.50 each month. If your plan offers a full $148.50 refund, you simply wouldn’t have a Part B monthly premium to pay.

  • May not save you money. Some Medicare Advantage plans come with additional out-of-pocket costs, such as a monthly premium for the plan, annual deductibles, or varying coinsurance or copays. Additionally, Medicare Advantage plans have a smaller network of providers, and seeing an out-of-network provider could cost you more.

If the plan’s coverage isn’t what you need, or your doctor isn’t in the plan’s network, you may be paying more than what you’re saving with the giveback program.

  • It could change. Because Medicare Advantage plans are offered by private insurance companies, they can set their own fees and costs, and change them each year. This means your plan could offer a certain reduction in your Part B premium one year, and then change it the next year.

Before deciding to enroll in a Medicare Advantage plan, do some research and compare different options available to you. Make sure the benefit of the Part B reduction outweighs any other downsides to enrolling in the plan, and that the plan’s coverage and network works for your needs. For official press release, please click here.