If the cost of Medicare has you worried, you’re not alone. Premiums, deductibles, and prescriptions can add up, and many people aren’t sure where to look for relief. The good news is that there are several places to start, from benefits built into some plans to programs based on income, to simple steps like shopping around.
Here’s a plain-English roundup of the main options, who they’re meant for, and where to go for more detail.
1. The Part B Giveback Benefit
Medicare Part B is a voluntary outpatient insurance program that helps pay for doctor visits, medical tests, and other healthcare services. You pay a monthly premium for it. Some Medicare Advantage plans offer a benefit called the Part B Giveback Benefit, which helps lower your Part B premium by a certain amount each month.
To be eligible, you must:
- Be enrolled in 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
You won’t receive a check from your plan. Instead, there are two ways the reduction shows up. If you pay your Part B premium through Social Security, the giveback is credited monthly to your Social Security check. If you don’t, you pay a reduced monthly amount directly to Medicare.
You can read the full explanation in our post on how to qualify to get back your Medicare Part B premium, and learn more about the basics on our Medicare Part B page.
2. Medicare Savings Programs
Medicare Savings Programs can help pay for your Medicare Part A and Part B premiums, deductibles, and copayments. Eligibility is based on income and assets. To apply, you can contact your state Medicaid agency or your local Social Security office.
3. Extra Help With Prescription Costs
The Extra Help program can help you pay for your Medicare Part D prescription drug premiums and out-of-pocket costs. Like the Medicare Savings Programs, eligibility is based on income and assets. You can apply for Extra Help through the Social Security Administration.
If you’d like a refresher on how drug coverage works, our Medicare Part D page explains the basics.
Other Programs Worth Asking About
There are a few other places to look. Some states offer programs to help low-income Medicare beneficiaries pay their Part B premiums. You can also check with your employer or union to see whether they offer any programs that help with Part B premiums.
The application process varies depending on the program. In general, you’ll need to provide documentation of your income and assets, and the program administrator can tell you how to apply.
4. Shopping Around for a Medicare Supplement
If you have a Medicare Supplement (Medigap) plan, you may have noticed your premium rising. Premiums typically go up each year for two main reasons: age and inflation. As you get older, the likelihood of health-related expenses increases, and inflation affects healthcare costs, so insurance companies adjust their rates. These increases can happen once or twice a year and can become more noticeable over time.
Our post on how Pennsylvania residents can save on Medicare Supplements walks through three options:
- Do nothing. This is the least recommended option, because premiums will keep rising and the increases can add up as the base premium grows.
- Switch to a different insurance carrier. Shopping around is one of the most effective ways to lower your premium, because insurance companies often offer lower rates to attract new customers, especially those in good health. Switching may require passing medical underwriting, so it helps to understand the questions and requirements first.
- Consider a Medicare Advantage plan. These plans often have lower premiums and may offer additional coverage, but you’ll need to make sure your doctors are in the plan’s network.
How much could you save?
According to our post, people who shop around for a Medicare Supplement plan save between $450 and $500 a year on average. Some save as little as $200, and others as much as $2,000. What you save depends on your own situation.
Do you need to check with your doctors?
If you’re switching from one Medicare Supplement plan to another, you don’t need to check with your doctors, because you’re still using Original Medicare for your primary coverage. Only the company that covers your additional costs, such as copays, deductibles, and coinsurance, changes. If you switch to a Medicare Advantage plan, you will need to make sure your doctors are in-network.
Choosing between Plan G and Plan N
When you first become eligible for Medicare, you’ll typically weigh Plan G against Plan N. Both cover most of the out-of-pocket costs Medicare leaves behind. The main difference is that Plan N has lower premiums but includes small copays for doctor visits or emergency room visits, while Plan G has no copays. If you’re focused on saving money while keeping solid coverage, Plan N may be worth a look.
A Simple Prescription Discount Option
If prescription costs are your main concern, a discount card may be worth exploring. GoodRx is a prescription drug discount card that works by negotiating discounts with pharmacies. You search for your medication on the GoodRx website or app, see the discounted price at participating pharmacies, and show the card to your pharmacist. Discounts vary by drug and pharmacy. Our post on what the deal is with GoodRx explains how it works.
Before You Apply or Switch
A little preparation makes any of these options easier. It helps to gather:
- Your current income and assets
- Your current plan details and monthly premiums
- A list of your medications
- Your doctors’ names, in case you’re considering a Medicare Advantage plan
Writing down your questions beforehand can also save you time and phone calls.
Local Help in Allentown and Kingston
Finding the right way to lower your costs is easier with someone who can look at your whole situation. Hitcho Insurance is a veteran-owned, independent Pennsylvania insurance agency, so we’re not tied to a single insurance company. We use our 4E process: Evaluate, Educate, Endorse, Enroll, to look at your coverage first and explain your options in plain English before recommending anything.
In Allentown: if you’re looking for Medicare advisors in Allentown, our Cedar Crest Boulevard office can sit down with you or talk by phone at (610) 694-9435, 1245 S Cedar Crest Blvd, Suite 200, Allentown, PA 18103.
In Kingston: if you’d like to talk with a Medicare insurance agent in Kingston, our Pierce Street office is ready to help at (570) 851-7676, 480 Pierce St, Suite 320, Kingston, PA 18704.
Schedule a consultation at the office closest to you, or browse our Medicare guide to learn more on your own. There’s no cost to meet with us. Carriers pay our commission, so you pay the same either way.