Do you still pay a Medicare premium if you have a Medicare Advantage plan?
Asked by: Mr. Hilbert Heidenreich MD | Last update: November 9, 2025Score: 5/5 (69 votes)
Do I have to pay Medicare premiums if I have a Medicare Advantage plan?
Of course, no Medicare Advantage plan is really $0 cost. You may still pay deductibles and copays for covered services, and you'll still have to pay the Part B premium. But depending on your own personal healthcare needs, a Medicare Advantage plan may be worth it for the added benefits.
Why are people leaving Medicare Advantage plans?
Key takeaways: People leave Medicare Advantage plans because out-of-pocket costs vary between plans, network restrictions can cause frustration, prior authorization requests can delay care, and it can be difficult to use the additional benefits they provide.
Why do doctors not like Medicare Advantage plans?
Across the country, provider grumbling about claim denials and onerous preapproval requirements by Advantage plans is crescendoing. Some hospitals and physician practices are so fed up they're refusing to accept the plans — even big ones like those offered by UnitedHealthcare and Humana.
How can Medicare Advantage plans not charge a premium?
Some Medicare Advantage (MA) plans don't charge any additional premium. You are already paying part B premiums, they just get rolled into part C if you choose an MA plan. Part A and B (straight Medicare) allows you to see any provider and does not have a wellness component.
Social Security Checks: February 2025 Payment Schedule Dates Update
What is the biggest disadvantage of Medicare Advantage?
- Plans can also cost more overall than Original Medicare if you have complex medical needs. ...
- With some plans, you don't have any coverage if you use a doctor that isn't in the network.
How do I avoid paying higher Medicare premiums?
Use Form Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event to report a major life-changing event. If your income has gone down, you may also use Form SSA-44 to request a reduction in your income-related monthly adjustment amount.
Is it better to have straight Medicare or a Medicare Advantage plan?
Both plans have formularies. Other benefits: Original Medicare does not cover vision, hearing, or dental services. Medicare Advantage plans may cover additional services, including vision, hearing, and/or dental, but those additional benefits may increase your premium and/or other out-of-pocket costs.
Why are hospitals dropping Medicare Advantage plans?
Health systems have cited delayed reimbursements, cumbersome prior authorization requirements and high rates of patient claim denials for their decisions to drop Medicare Advantage plans.
Does everyone have to pay $170 a month for Medicare?
Most people pay no premiums for Part A. For Medicare Part B in 2025, most beneficiaries will pay $185 per month. Certain factors may require you to pay more or less than the standard Medicare Part B premium in 2025.
Why are seniors losing Medicare Advantage plans?
Medicare vs Privatized Medicare Advantage
Beneficiaries are tossed aside because they live in an unprofitable market for their insurer or because they are actually using the insurance they signed up for to access services.
Can I drop my Medicare Advantage plan and go back to original Medicare?
Medicare Advantage Open Enrollment Period: Between January 1 and March 31 of each year, if you already have a Medicare Advantage Plan (with or without drug coverage) you can: Switch to another Medicare Advantage Plan (with or without drug coverage). Drop your Medicare Advantage Plan and return to Original Medicare.
Why is a medicare supplement better than an advantage plan?
Consider Original Medicare with a Medigap plan if you:
Original Medicare with a Medigap plan gives you access to any doctor or hospital that accepts Medicare. Intend to travel. Medicare Advantage plans come with limited service areas; if you travel outside, you may have to pay out of pocket for medical care.
Do you need Medicare supplement if you have an Advantage plan?
A Medicare Advantage Plan is another way to get your Medicare coverage besides Original Medicare. A Medigap policy is a supplement to Original Medicare coverage. When you're getting started with Medicare, you can either buy Medigap or enroll in a Medicare Advantage Plan, but you can't have both.
Why is Social Security no longer paying Medicare Part B?
There could be several reasons why Social Security stopped withholding your Medicare Part B premium. One common reason is that your income has exceeded the threshold for premium assistance. Another reason could be that there was a mistake or error in your records.
How do you qualify for $144 back from Medicare?
- Be enrolled Original Medicare (Parts A and B)
- Pay your own Part B premium.
- Live in the service area of a plan that offers a Part B giveback.
Why do some doctors not take Medicare Advantage plans?
Can Doctors Refuse Medicare? The short answer is "yes." Thanks to the federal program's low reimbursement rates, stringent rules, and grueling paperwork process, many doctors are refusing to accept Medicare's payment for services. Medicare typically pays doctors only 80% of what private health insurance pays.
What is the two midnight rule for Medicare Advantage?
The two-midnight presumption directs medical reviewers to select Original Fee-for-Service Medicare Part A claims for review under a presumption that hospital stays that span two midnights after an inpatient admission are reasonable and necessary Part A payment.
Why are Advantage plans being discontinued?
Advantage insurers such as Humana have recently struggled with rising medical costs as their members seek more care. Some insurers are exiting unprofitable markets for 2025, and about 1.5 million enrollees will see their plan eliminated, according to Healthpilot, a digital Medicare broker.
What is the best Medicare plan that covers everything for seniors?
Original Medicare with Medigap likely offers the most comprehensive coverage, but it may also be the most costly. A person can consider their income and how much they are able to spend before choosing a Medicare plan. Original Medicare with Medigap also offers a lot of flexibility when choosing a doctor or specialist.
What is the downside of a Medicare Advantage plan?
Disadvantages of Medicare Advantage plans can include difficulty switching out of the plans later, restrictions on care access, limited provider networks, and limitations on extra benefits.
What are the 6 things Medicare doesn't cover?
- Eye exams (for prescription eyeglasses)
- Long-term care.
- Cosmetic surgery.
- Massage therapy.
- Routine physical exams.
- Hearing aids and exams for fitting them.
How do you not have to pay Medicare premiums?
You're eligible for Part A at no cost at age 65 if 1 of the following applies: You receive or are eligible to receive benefits from Social Security or the Railroad Retirement Board (RRB). Your spouse (living or deceased, including a divorced spouse) receives or is eligible to receive Social Security or RRB benefits.
What does social security extra help pay for?
The Extra Help program helps with the cost of your prescription drugs, like deductibles and copays. You can apply for Extra Help any time before or after you enroll in Part D.
How much is taken out of your social security check for Medicare?
Most people pay the standard Part B monthly premium amount ($185 in 2025). Social Security will tell you the exact amount you'll pay for Part B in 2025. You pay the standard premium amount if you: Enroll in Part B for the first time in 2025.