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Old 01-29-2018, 06:38 PM
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Default Medicare Advantage Question

In Medicare Advantage plans, how do members that have a plan that covers RX pay their Part D premium? Are they paying the premium to the MCO? Or to the government along with Part B premiums?

I see some Medicare Advantage plans saying they are $0 premium plans. Trying to understand what is/isn't included in that $0 premium definition.

Last edited by bigb; 01-29-2018 at 06:45 PM..
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Old 01-29-2018, 07:09 PM
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Most plans are MAPD plans, meaning they replace Medicare coverage for Parts A, B, and D. If the plan covers Part D, there would be no premium required to the MAPD carrier for either Medical or Rx coverage on a $0 premium plan; members would still pay their standard Part B premium to the government.
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Old 01-29-2018, 08:51 PM
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Originally Posted by cincinnatikid View Post
Most plans are MAPD plans, meaning they replace Medicare coverage for Parts A, B, and D. If the plan covers Part D, there would be no premium required to the MAPD carrier for either Medical or Rx coverage on a $0 premium plan; members would still pay their standard Part B premium to the government.
In such a case how is the government getting the beneficiary Part D premium?
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Old 01-29-2018, 09:09 PM
cincinnatikid cincinnatikid is offline
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In such a case how is the government getting the beneficiary Part D premium?
The issuer uses the savings from bidding below the county benchmark to reduce the part D base premium to $0.
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Old 01-29-2018, 09:14 PM
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The issuer uses the savings from bidding below the county benchmark to reduce the part D base premium to $0.
Thanks.
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Old 02-07-2018, 07:06 PM
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Originally Posted by cincinnatikid View Post
Most plans are MAPD plans, meaning they replace Medicare coverage for Parts A, B, and D. If the plan covers Part D, there would be no premium required to the MAPD carrier for either Medical or Rx coverage on a $0 premium plan; members would still pay their standard Part B premium to the government.
Sometimes there is a Part B Premium giveback. Not very often and only in certain counties where benchmark rates are crazy high (Dade County FL?).
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Old 02-22-2018, 02:30 PM
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Sometimes there is a Part B Premium giveback. Not very often and only in certain counties where benchmark rates are crazy high (Dade County FL?).
This is correct. Only a handful of counties have true $0 premium plans. Every person in a $0 Premium MAPD plan still have to pay their Part B Premium (which is taken out of their Social Security Checks...so the member doesn't actively make a payment).

In a handful of counties, the MAPD plans can buy down a portion (or most) of the Part B Premiums, which results in a higher Social Security check in terms of their take home.

Outside of high benchmark counties, you may occasionally see a plan with VERY lean benefits and then tack on a Part B Giveback benefit.
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