'Medicare at No Cost to You!' Really?

'Medicare at No Cost to You!' Really?
gerenme / Getty images

(Updated Dec. 10, 2020)

 

You gotta love the marketing pitches of those Medicare Advantage plans – the ones popping up online and on your TV at all hours during open enrollment season.

 

You’ve seen their “$0 premium” pitches, but these plans are not as “free” as they imply. Does that surprise you?

 

[RELATED: MOAA’s TRICARE and Health Care Resources]

 

Those ads are really saying that the plan carries no "premium" cost above your Part B Medicare premium. You still have to pay Part B premiums. And the ads do not mention other possible costs, which could include:

  • The higher cost of co-pays or co-insurance.
  • The higher deductibles.
  • The higher yearly limit on your out-of-pocket costs for all medical services.
  • The fact that you’ll have to go where they tell you go for services.

 

 

These companies are going to get their pound of flesh one way or another, or they wouldn't be in business.

 

Remember, Medicare comes in two flavors: Original Medicare is government insurance, but the government allows private health insurers to get in the game by offering Medicare Advantage plans. Advantage plans have to offer no less coverage than Original Medicare by law, but they can offer more. And they can charge as they wish for the extras.

 

These pitches are for Medicare Advantage plans. You can choose one if you want to get the extra services. The $0 amount is how much extra premium they charge above the standard Part B premium.

 

Technically, TFL supplements Advantage plans as it does Original Medicare since all are Parts A and B Medicare. However, TFL does not link with an Advantage plan in-system as Original Medicare does. That means claims will not flow automatically and seamlessly through the computer from Advantage plan to TFL as they do with Original Medicare.

 

You will probably have to file manual claims to TFL to have expenses that fall out of the Advantage plan reimbursed. You can call TFL to determine if coordination between TFL and an Advantage plan is possible by calling TFL at (866) 773-0404.

 

[RELATED: TRICARE Over 65: Medicare Information]

 

If you are wading through the ads as you shop for an Advantage plan, here’s one final thing to keep in mind: Be careful of Advantage plans that come with Part D (drug) plans. You do not want one.

 

Having another drug plan messes with your TRICARE pharmacy plan. You won’t be able to use the Express Scripts home delivery program, and you’ll have to file manual claims with TRICARE.

 

The bottom line: Look at all the costs when comparing plans to determine what makes the best sense for you.

Related Content

About the Author

Lt. Col. Shane Ostrom, USAF (Ret), CFP®
Lt. Col. Shane Ostrom, USAF (Ret), CFP®

Ostrom is MOAA's former Program Director, Financial & Benefits Education/Counseling