There have been a few questions surfacing lately from clients seeing ads that say ‘Medicare Benefit of up to $164.90 Back’ and ‘See if you qualify for up to $164.90 per month.’ Because of these questions, we thought this would be an ideal topic to tackle so that you can feel a little more informed.
Karen Kukura is an insurance agent with Medicare Insurance Specialty Group out of Knoxville, TN, and the surrounding areas. She helps her clients understand the basics of how Medicare works, what it does and doesn’t cover; breaking it down to make it easily understood. She uses an individual approach in helping her clients find the best plan(s) that meet their unique financial, medical, and prescription drug needs. She assists clients with Tenncare/QMB and Extra Help (with prescription drug) applications. Karen represents several Medicare Supplement, Medicare Advantage, Prescription Drug, and Dual Eligible Plans here in Tennessee. She is very customer service oriented and available all year for questions that may come up. In her free time, Karen enjoys spending time with her husband of 29 years and two boys ages 25 and 23.
What is this $164.90 back benefit?
The giveback benefit is actually part of the Part B premium reduction that first appeared in 2003. A Federal regulation allowed for a reduction in payments of the Medicare +Choice plans and that helped to fund the giveback. It originally was $144, NOW it’s $164.90!
How do you qualify for up to $164.90 back?
There are thre dcommon ways to get up to $164.90 back on Medicare premiums.
1. Qualify by your income and assets. Basically, the state will pay for your Part B premium which in 2021 is $148.50. Income limits are listed below. Each state will be a little different with qualification requirements and applications. We will use Tennessee for this illustration.
- You will need to complete the Medicare Savings Application with the state
- Assets do not include the home you live in.
- It does include ALL income, not just Social Security. This also includes income from 401k’s, pensions, etc.
Basic limits for Tennessee as of 03/01/2021
- QI-1 – Singles: $1549 a month income/$9090 resources
- SLMB- Singles: $1379 a month income/$9090 resources
2. The second way is by choosing a Medicare Advantage plan that does not have a prescription drug plan included. A plan without prescription drug coverage may “give back” a certain amount of money because you do not have a prescription drug plan.
- This plan option is usually good for Veterans who get their prescriptions from the VA
- If someone has a prescription drug plan that is considered “creditable coverage with Medicare”.
- You can only be in one Medicare Advantage or prescription drug plan at a time so you cannot choose a Medicare Advantage plan without prescription drug coverage and have a separate stand-alone prescription drug plan.
- If you do not have a prescription drug plan that is considered creditable coverage with Medicare and you decide to enroll in a prescription drug plan later, you will incur a late enrollment penalty when you do sign up.
- The second way is by choosing a Medicare Advantage plan that does not have a prescription drug plan included. A plan without prescription drug coverage may “give back” a certain amount of money because you do not have a prescription drug plan.
- This plan option is usually good for Veterans who get their prescriptions from the VA
3) REBATE PLANS: Some Medicare Advantage plans may part of your Part B premiums, however they tend to have higher co-pays and max out of pockets.
Always Be Wary of Scams
Remember to watch out for ads that say “you may” qualify. The keyword here is MAY. Also, these are usually ads that come from insurance agents or companies that sell leads to agents. Medicare or Social Security will never call you and if you are getting a letter from them it will clearly state who it is from. It will be directed to you and it will be OBVIOUS that it is real. Remember most agents can help you figure out if this is important or not and can help you with all of these applications so ask your agent first!
>>Related Read: Medicare TV Ad Scams
Additional Benefits Possible
Along with “What is $164.90 back?” yet another question we hear all the time is “am I getting every benefit I can?”
Things to consider:
• Ads you see can list all the benefits that are on every plan, everywhere.
• No plan will have every benefit in existence.
• Some benefits may not be offered in your county or state. For example, Alaskan residents get annual oil revenue dividends, but residents of other states don’t get these benefits.
• If you pick a plan with a $0 premium you may get fewer benefits than a plan with a premium. Some plans may offer more dental or vision, yet a plan with another company may offer better-hearing benefits.
It’s not so much if you are getting every benefit there is, it’s about finding the plan that has the benefits that fit your needs! If you have an agent, call them first. If they are an independent insurance agent, they will be contracted with many plans so they can assist you and help you find the plan that has the most benefits to fit your needs.
If you still have questions and need some help, please don’t hesitate to reach out to us. That’s what we are here for!
*Medicare Insurance Specialty Group is Not Approved By, Endorsed By, or Affiliated With A Government Agency. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.