Is Medicare Part B Available For Higher-Income Seniors?

Question: I get a lot of phone calls and mail from companies offering to pay my Medicare Part B. Is that available to me, I have a high income?

Answer: Happy Insurance Season! This time of year, from October to December, every year individuals with Medicare receive mail and phone calls advertising all the different insurance products available. Each year the marketing of Medicare Advantage Plans seems more and more aggressive. There are even TV programs and TV channels dedicated to the Medicare Advantage Plans.

Almost every insurance company offering Medicare Advantage Plans has included this benefit called a Part B Buy Back in at least one of their plans. Your Medicare Part B premium in 2024 is $174.70 and comes directly out of your Social Security monthly benefit. This Buy Back benefit means the insurance company will pay part of your Medicare Part B premium as long as you are enrolled in their insurance product offering this benefit. The plans offer between $4 and $90 toward your Medicare Part B premium. This money is paid to SSA and your Social Security monthly deposit will go up by the amount offered from your plan of choice.

A Part B Buy Back may be a benefit to you but this should not be your only consideration.

Medicare Advantage plans are insurance products that bundle your benefits. Your hospitalization, your outpatient and your prescription drugs are included in one package. So all of those factors should be included in your analysis of the product. Do your doctors participate in this plan? Are the hospitals you want to use included in this coverage? Not all Medicare Advantage Plans participate at all the hospitals in our region. Does the plan cover your current medications? Is your pharmacy a preferred pharmacy?

Consequently, enrolling in a product that gives you $90 back in your Social Security and then having to pay more for your prescriptions was not an overall beneficial decision.

Very often individuals tell us that when these calls come to their home, the person introduces themselves as “someone calling on behalf of Medicare”, or “They are calling to inform you of Medicare Benefits available to you”. Both of these phases are not entirely wrong and not entirely true. The person calling you represents an Insurance Company that has contracted with Medicare to provide insurance products. They are not calling from Medicare. Center for Medicare & Medicaid Services (CMS) will not call you, unless you have made a request of some sort with CMS and they are returning your call.

The benefits Medicare Advantage Plans offer in their coverage, (like the Part B Buy Back, or a health club membership, or dental cleanings and exams, or $30 in Over the Counter (OTC) products each quarter) are NOT benefits included in Original Medicare. These are benefits that Medicare Advantage Plans add on above and beyond the health insurance products they offer as a way to entice you into enrolling with them.

Medicare Advantage Plans are paid by Medicare to offer these insurance products. When you enroll in a Medicare Advantage Plan, CMS sends your Part B payment to the Insurance Company for every month you are enrolled in the plan. These payments are adjusted to reflect the costs incurred by the Medicare Advantage Plan in covering the individuals already enrolled in the product. This monthly payment could be anywhere from $300 to $900 per month for each individual enrolled in the plan paid to the insurance company by CMS. That is how the Medicare Advantage Plans can afford to offer all these benefits above and beyond what Original Medicare covers.

That is why you are receiving so many of these mailings, and so many of these calls this time of year. The Insurance companies are aggressively competing for your business. They want you enrolled in their plan. You need to be sure the plan meets your needs on all fronts. The $4 to $90 offered towards your Medicare Part B is a very small factor overall.

Janell Sluga is a Geriatric Care Manager helping seniors in our community access services and insurance. To reach her, please email editorial@post-journal.com.


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