Current advertising often references a Medicare rebate, also known as a Medicare, give back benefit. This has been an available benefit for Medicare Part B since 2003 but is now more popular than ever. Although rebates and saving money is appealing, there are some eligibility requirements and factors you should pay close attention to before assuming that taking advantage of the rebate is the best approach for you.

What is Meant by a Medicare Give Back Benefit?

The Medicare Part B give back is not a government plan offered by Medicare. It is only offered by some Medicare Advantage Plans (Medicare Part C). The give back may cover some or all your Part B monthly premium. For 2022, most people will pay a Part B monthly payment of $170.10. Some may pay more depending on their monthly income. When there is no Social-Security cost-of-living-adjustments you may pay different premiums then others.

When you are shopping for a Medicare Advantage Plan take into consideration, among all the other factors, whether the best plan for you offers this Medicare rebate.

What are the Eligibility Requirements for Receiving the Give Back Benefit?

To qualify for the Medicare Part B premium reduction, you must:

  • Be enrolled in Medicare Part A and Part B.
  • You pay your Part B premium without any government assistance.
  • You enroll in a Medicare Advantage (Medicare Part C) plan that offers a giveback benefit.
  • You reside in the zip code where the Medicare Advantage plan provides coverage.

There is more to an Advantage plan than just providing you a rebate. Check carefully the benefits provided by the plan to be sure the plan will meet your needs. It is a bonus to you if it then offers a giveback.

How Do I Receive the Rebate?

Each Medicare Advantage Plan is different. Check the plan’s summary of benefits section, also known as evidence of coverage (EOC). This is where you will find an explanation of how the specific plan’s Part B premium buy-down works:

  • You may not actually receive cash back.
  • You may receive the benefit by way of paying the reduced premium.
  • Typically, you may see this in the amount of your Social Security retirement check.
  • Since Medicare Part B is normally paid out of your Social Security benefit check, your Social Security check could be more when a lesser amount is being deducted from it for your Medicare Part B premium.

If you do not pay by having the amount deducted from your Social Security check and instead pay the monthly premium when you receive your Medicare monthly statement, the rebate amount may be credited to your monthly statement, and you may only pay the amount due after the rebate has been credited.

Medigap plans, or Medical Supplemental Insurance plans, do not offer any Part B premium reduction or any type of give back benefit. The difference is that Medigap plans provide secondary coverage to Original Medicare and only pay after Original Medicare has paid its part. Medicare Advantage plans take the place of Original Medicare.

What are the Drawbacks to Medicare Part B Giveback?

Everyone likes the idea of saving money. Even so, there are some downsides to the Medicare giveback benefit which include the following:

  • Not all Medicare Advantage plans that offer the give back are available in all service areas. There may not be one available in your geographical area.
  • The Medicare Advantage plan that offers the rebate may not offer the range of benefits you are looking for. Advantage plans cover everything that is covered by Original Medicare, and they generally offer a whole lot more benefits, such as dental, vision, and hearing, benefits that are not offered by Original Medicare.
  • Some plans that offer the Medicare Part B give back do not offer the extra benefits to make up for their offering you what is essentially a lower premium.
  • The plan may have higher co-pays, co-insurance, and deductibles. The benefit of the Medicare Part B rebate may not be enough to make up for the other higher costs.
  • The amount of the give back varies with the plan and geographical area. One plan in one area offers a give back as low as just $1. Probably not very enticing to most people. One that offers a give back of the full cost of the monthly premium of $170.10 is likely more attractive. Again, be sure the benefits being offered are not less than the benefits you need and are looking for.
  • The amount of the give back benefit can change. Private insurance companies offer Medicare Advantage plans. These companies set their own fees and these fees are not regulated by the federal government. What seems like a good savings for you this year may change, and the rebate eliminated or substantially reduced next year.

Sources:

  1. Medicare Give Back Benefit, American Association for Medicare.