zero-premium plan

What is a zero-premium Medicare Advantage plan?

A zero-premium plan is a Medicare Advantage plan that has no monthly premium (other than the Medicare Part B premium). In other words, you don’t pay anything to the insurance company each month for your coverage. More than three-quarters of Medicare Advantage enrollees are in zero-premium plans.¹ But across all Medicare Advantage plans with integrated Part D coverage (MA-PDs), the average premium is projected to be about $11.50/month in 2026.²

Will I still have other costs if I enroll in a zero-premium Medicare plan?

If you have a zero-premium plan, you pay $0/month to your Medicare Advantage insurer. But all enrollees pay the Part B premium ($202.90/month for most enrollees in 2026),³ unless they are also enrolled in Medicaid, a Medicare Savings Program, or a Medicare Advantage plan that pays some of the Part B premium on their behalf.

So if you have a Medicare Advantage plan that costs about $30/month, you’ll pay about $233/month in total premiums. But if you have a zero-premium Medicare Advantage plan — which is true for the majority of enrollees — you’ll only pay the $202.90/month for Part B (note that the Part B premium is higher if you have income above $109,000/year).

Who can buy a zero-premium plan?

Almost all Medicare Advantage enrollees (99%) had access to at least one zero-premium plan for 2025, and about three-quarters of Medicare Advantage enrollees select a zero-premium plan. But about 9% of 2025 Medicare Advantage enrollees were in plans with premiums of at least $50/month.¹

Why might I not buy a zero-premium Medicare plan?

So why would people opt to pay premiums for Medicare Advantage coverage when they could have a free option instead? There are a variety of reasons, including provider networks, drug formularies (ie, covered drug lists), and total costs. In some cases, the provider networks for the zero-premium plans might not include an enrollee’s current doctors. Or they might have drug formularies that don’t include the medications a person is taking.