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What Is The Medicare Giveback Benefit? Tips for Eligible Beneficiaries

What Is the Medicare Giveback Benefit?

The Medicare giveback benefit is a rebate offered by some Medicare Advantage (Part C) plans. The private insurers that sell these plans sometimes offer a discount on your Part B monthly premium. In 2023, this premium starts at $164.90 each month, and some companies might offer you up to this amount as a monthly discount. Typically, you receive this money as a bonus on your monthly Social Security check.

One of the prominent features of the Medicare Giveback Benefit is its impact on Social Security payments. For many, the giveback benefit translates into a more substantial monthly Social Security check, providing additional financial relief.

Help Reduce Medicare Advantage Costs With the Giveback Benefit

Medicare Part C plans include both Medicare Part A and Part B benefits and are sold by private insurers. If you choose one of these plans, you pay a monthly premium to the insurance company and your Part B premium. Some insurance companies do not charge a premium, but even in these instances, you still have to pay your Part B premium.

Whenever you sign up for Part C with a private company, that company receives payments from Medicare. The company can choose to receive a lower payout and then reduce your Part B premium in the form of a Medicare giveback benefit. 

How Does the Medicare Advantage Giveback Plan Work?

Every insurance company offering Medicare Advantage plans is reimbursed by Medicare for providing services. These plans offer the same Part A and Part B benefits but bundle in other services like dental and vision care. Medicare Part B, in particular, covers medically necessary and preventive services, such as annual wellness visits, screenings, and mental health treatment.

Because the company is paying your Part B premium on your behalf, you can receive a monthly refund if the insurance company accepts a lower payout from Medicare. According to regulations, 80% of an insurance company’s payment reduction has to be applied to Part B premium reductions.

If you usually pay your premium through your Social Security benefits (which is common), this means you get more on your check. For example, if your insurance company offers to pay $100 of your premium and your usual Social Security check is $1,200, you get a $1,300 check each month instead. It’s a great way to get more money in your wallet.

Eligibility

Eligibility varies depending on your insurance company, but there are a few general guidelines:

  • Enrolled in Medicare: To become eligible, you must be enrolled in Medicare Parts A and B and pay your own premiums.
  • You cannot receive government or Medicaid assistance in paying your Part B premium: Since you’re already receiving assistance, your insurance company cannot also offer assistance.
  • You must live in specific areas: Not every state permits the Medicare giveback benefit, so check with your specific plan to know if you may be eligible.

How Much Could You Get Back?

Federal guidelines require the Medicare giveback benefit be a multiple of 10 cents. You cannot receive less than that. It can go up to the standard Part B premium amount for the given year, which is $164.90 in 2023. This premium generally increases each year (though it did decrease from $170.10 in 2022). In 2022, more than 60% of states only offered plans with a giveback benefit of $99 or less, so many people do not receive a full premium rebate.

Giveback Benefit vs. the Medicare Savings Program

The Medicare Savings program offers another way to save money on Medicare each month. This state-managed, income-based program helps individuals pay for their Part B premiums, deductibles, and copayments. This makes it more worthwhile than the giveback program, which only covers premiums and not other out-of-pocket costs.

Because this program is income based, you must make less than a certain amount each month. In 2023, income limits range from $1,235 to $1,663 a month for individuals. On the other hand, the Medicare giveback benefit applies to everyone enrolled in specific, qualifying health plans, with no stipulation on income. 

Consider a Medicare Savings Program If…

In general, a Medicare Savings Program makes sense if:

  • You make less than $1,660 a month.
  • You do not want (or cannot afford) the additional coverages offered by a Medicare Advantage plan.
  • You do not have savings, stocks, or bonds (Individuals cannot have more than $9,090 in available resources).
  • Your state has lax guidelines on incomes and resources (some have higher limits than the national guidelines).

How to Enroll in a Medicare Savings Program

To enroll in a Medicare Savings Program, reach out to your state’s official Medicaid office, as each area has a different application procedure. You may need to verify your income and Medicare enrollment before officially enrolling.

How to Get a Medicare Advantage Plan With the Giveback Benefit

Enrolling in Medicare Advantage giveback plans is straightforward if you follow these steps.

1. Review the available plans in your area

Medicare Part C availability differs by area, so to find plans near you, use the Medicare plan search tool. Input your ZIP code and choose “Medicare Advantage Plan (Part C).” Answer any additional questions to view your available plans.

2. Compare your options

Once you see the list of available plans, click “Plan Details” on any that interest you. Under the “Premiums” section is a line that reads “Part B premium reduction.” If it says “Yes,” then that plan comes with a giveback benefit, though you will not know how much until you enroll. Also, consider the plan’s monthly premium, benefits, and deductible before making a final selection.

3. Work with a licensed agent to find plans with the giveback benefit

If this process sounds too confusing, you can work with a licensed agent to find the healthcare plan that’s right for you. After asking you about your health goals, budget, and desired benefits, an agent can search through available plans and find one that meets your needs.

4. Select the plan that best meets your coverage needs

Make sure whatever plan you’re looking at has enough benefits. Many people prefer plans that include vision, dental, and hearing coverage. Also, consider deductibles and copayments; are these affordable if you must go to the doctor often? Finally, check to make sure your providers are in your insurance network.

5. Wait for the next applicable enrollment period and apply

You can join a Medicare Advantage plan three months before and three months after signing up for Medicare. Otherwise, you need to wait for Open Enrollment. General Open Enrollment is between Oct. 15 and Dec. 7, but there’s also a special Medicare Advantage Open Enrollment Period between Jan. 1 and March 31 if you already have a Medicare Advantage plan.

6. Apply for the Medicare Part B giveback benefit with your plan

After you’ve enrolled in your plan, you usually start receiving the Medicare Part B giveback benefit automatically. If not, be sure you apply and consider the following.

Required Documentation

Insurance companies have their own process for setting up your giveback benefit, and yours likely got the documentation it needed from you when you signed up for a plan. But just in case, have the following handy:

  • Your Social Security number
  • A Social Security statement

Timeline For Decision

Your Medicare giveback benefit starts as soon as your Medicare Advantage plan starts. Sometimes though, it can take up to three months for the benefit to be reflected on your Social Security check. If that happens, you eventually receive credit for the missing months.

All in All

If you’re looking for a way to make your health insurance costs more affordable, the Medicare Giveback benefit is one way to do it. As long as you choose a plan that offers it, you can receive this benefit automatically each month for as long as you have the plan. And since the money comes to you in the form of more money on your monthly Social Security check, it feels less like a refund and more like a bonus.

Consider switching to a Medicare Advantage plan to take advantage of this monetary incentive. There are options to suit both your medical needs and your budget.

You’re just a few steps away from seeing your Medicare Advantage plan options.

Find a plan

You’re just a few steps away from seeing your Medicare Advantage plan options.

Find a plan