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How the Medicare Part B giveback might save you money

Medicare Advantage marketing touts Part B premium reductions, but they're only available on certain plans, and may not be the plans that best fit your needs

Louise Norris | December 16, 2022

Reviewed by our health policy panel.

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During the annual Medicare open enrollment period, you’ll likely see commercials for a “giveback” or “premium reduction” rebate that will reduce the amount you have to pay for Medicare Part B. Here’s what you need to know about how this works:

Most Medicare beneficiaries qualify for premium-free Medicare Part A, based on their work history or their spouse’s work history. But Medicare Part B has a monthly premium, which is $164.90/month for most beneficiaries in 2023.

What is the Medicare Part B giveback?

If you choose to enroll in a Medicare Advantage plan, you pay the premium for Part B plus the premium for the Advantage plan. As of 2023, two-thirds of all Advantage plans have $0 premiums, which means their enrollees just pay the Part B premium.

But some of those plans go a step further, offering “giveback” rebates that pay a portion of their enrollees’ Part B premiums. This benefit, also referred to as a Medicare Part B premium reduction, has been available since 2003. And although most Advantage plans do not offer a giveback rebate, the benefit has become more popular and widespread in recent years, and is increasingly marketed as a stand-out benefit by Medicare Advantage plans that do offer it.

How does a Part B giveback rebate work?

The specifics of the giveback rebate rules are outlined in federal regulations that have been applicable since Medicare+Choice plans were rebranded as Medicare Advantage. Medicare Advantage plans receive payments from the federal government (which cost the government more per person than it spends on Original Medicare). But the plan can opt to receive a reduced payment and use the payment reduction to offset some of the Part B premium for its enrollees.

How large are the Part B givebacks?

For plans that take this option, the Part B premium reduction can be as little as 10 cents, or as much as the full Part B premium, which is $164.90/month in 2023. The Part B premium reduction has to be provided uniformly to a plan’s enrollees, so everyone in the plan gets the same Part B premium reduction.

How do you receive the Part B giveback?

For most Medicare beneficiaries, the cost of Part B is deducted from their Social Security checks. Beneficiaries who don’t receive Social Security retirement benefits are invoiced directly for their Part B premiums. The giveback rebate can be used by people in either scenario: If you’re receiving Social Security retirement benefits and you enroll in an Advantage plan with a giveback rebate, the amount that’s deducted from your check to cover the cost of Part B will be lower. And if you pay your premiums directly to Medicare, you’ll be invoiced a smaller amount.

Where is the Part B giveback offered?

The commercials for Medicare Advantage giveback rebates are aired nationwide, although plans that offer this benefit are not available in all areas. But giveback rebates have become more common in recent year, and most areas of the country do have at least one Medicare Advantage plan that offers this benefit as of 2023. However, even if you’re in an area where this benefit is offered by at least one Advantage plan, it’s likely that the majority of the available plans will not offer it.

Assuming there are Medicare Advantage plans in your area that offer a giveback rebate, it’s important to evaluate all of the available plans based on how they’ll serve your overall needs. If a plan has a $50 giveback rebate but will end up costing you an extra $60 every month at the pharmacy, or doesn’t include your doctors in its network, it’s probably not going to be your best option.

How is the marketing of giveback rebates regulated?

CMS is looking into the marketing around giveback rebates, and addressed it in proposed rulemaking that was issued in late 2022. CMS notes that the nationwide marketing of giveback rebates equal to or near the full amount of the Part B premium is a “misleading tactic that is more likely designed to attract a beneficiary’s attention so that the beneficiary will call the number and then be subject to additional marketing and potentially switched to a plan that is not well suited to meet the beneficiary’s health care needs.” Specifically:

  •  Although the giveback rebates were marketed nationwide as being “up to $144/month,” plans with rebates of at least $140/month were only available in some areas of California, Florida, and Puerto Rico as of 2022. In 60% of states, the largest giveback rebate available in 2022 was $99/month or less.
  • In some cases, beneficiaries call to get more information based on the marketing of a giveback rebate amounting to all or nearly all of the Part B premium, and find out that the available rebate is much smaller, in the range of $1 to $25 per month.
  • There does appear to be some level of bait-and-switch involved. CMS has listened to recorded phone calls in which a beneficiary calls an advertiser to ask how they can get $144/month added to their Social Security check (based on marketing materials the beneficiary saw), but the agent then offers a plan with no rebate or a much smaller rebate. CMS states: “Because of the initial call, which was based on unavailable benefits, the beneficiary may end up enrolling in a plan that does not best meet the health care needs of the beneficiary. In this situation, the beneficiary may have benefited by staying in their existing plan, and may even have stayed enrolled in their existing plan, if not for the advertisement urging the beneficiary to call to “get the money they deserve.”

To address these issues, CMS has proposed that Medicare Advantage and Part D insurers “may not engage in marketing that advertises benefits that are not available to beneficiaries in the service area where the marketing appears unless unavoidable in a local market.” If finalized, this would take effect in 2024.

For now, if you’re seeing marketing for significant giveback rebates, be aware that these benefits may or may not be available in your area, and that the plans offering them may or may not be the option that works best for your particular needs.

How can I find Medicare Advantage plans with a Part B giveback

When you’re comparing plans on the Medicare Plan Finder tool, you can click on “plan details” to see more information about each plan. An overview page will appear, and the section at the top is all about premiums. The fourth line is labeled “Part B premium reduction” and it will either say “yes” or “no” depending on whether the plan offers a Part B giveback rebate. You can also call the Medicare Advantage insurers in your state to ask them directly about whether they offer this benefit.

What factors – other than premium – should I consider when choosing a Medicare Advantage plan?

The total monthly premium is just one aspect of your coverage, and there are numerous other features that you’re going to want to take into consideration when you’re making a plan selection. For example:

  • How will the plan cover your specific prescription drugs, and what pharmacies are in-network? (Most, but not all, Medicare Advantage plans include integrated Part D prescription coverage.)
  • Which doctors and hospitals are in the plan’s provider network?
  • What are the total out-of-pocket costs that you’re likely to have under the plan? (Keeping in mind that the out-of-pocket maximum listed for each plan doesn’t include prescription costs, which are counted separately.)
  • What additional benefits does the plan provide, and how much value will you get from them? This can include coverage for things like over-the-counter drugs, in-home support, dental services (plus extras like endodontics and periodontics), hearing aids, gym memberships, and more. Particularly for people with certain chronic medical conditions, Medicare Advantage plans are increasingly offering additional supplemental benefits, but you have to qualify for these based on your medical needs.
  • What star rating does the plan have? (Just like giveback rebates, this shouldn’t be a starting point for picking a plan, but rather a means of narrowing down the options once you’ve selected a plan that provides the overall benefits that fit your needs.)

So is a Medicare Advantage plan with a giveback rebate a good choice for you? Maybe. But it will depend on the other features of the plan, and it’s important to base your decision on how the plan will serve you overall, rather than just the heavily marketed features.

Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.

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