What is a Medicare Give Back Benefit and How to Find a Plan With It

• Some Medicare Advantage plans provide a rebate on a portion of the Part B monthly premium. This rebate is referred to as a Medicare give back benefit. 
• A Plan B premium reduction through the Medicare give back benefit can range from $10 to over $100 a month.
• Rebated money for the Medicare Part B monthly premium is one of many perks plans can offer and should be looked at as a single part of a more comprehensive plan.

Plenty of commercials advertise policyholders who receive a Medicare refund, thanks to a Medicare give back benefit. This benefit exists for some Medicare Advantage policyholders and may be worth considering when it’s time for the initial enrollment or open enrollment period. 

To learn more about the Medicare giveback benefit and other perks of certain Medicare Advantage plans, keep reading. 

Medicare is a federal health benefits program that provides medical insurance to Americans over 65. While someone can receive this healthcare coverage through the government, it’s also possible to opt for a Medicare Advantage (MA) plan which is offered through private insurance companies and bundles more coverage options.

Medicare Advantage plan, also known as Medicare Part C, is a Medicare option that covers parts A and B through private insurance. Not to mention, most plans include Part D prescription drug coverage alongside additional coverage for dental, hearing, vision, and more.

Plan coverage includes:

• Hospital visits
• Certain expenses associated with hospice
• Nursing care in assisted living facilities or home health services.
• Outpatient care
• Doctor’s appointments
• Preventative services
• Medical supplies

Note: For more information about Medicare Advantage plans and what they offer, visit this resource.

One benefit offered by some MA plans is a premium reduction. This giveback benefit reduces someone’s Medicare Part B premium, resulting in ​“money back.” When a give back discount is offered, Medicare Advantage plans can return as much as $10 to over $100 a month. According to KFF, about 19% of Medicare Advantage plans qualify for this benefit.

Considering that the standard Part B premium is $174.40 in 2024, a plan with a give back scheme can provide significant savings. If someone pays the part B premium out of Social Security, the rebate shows up as an increase in monthly Social Security checks. For those who haven’t claimed social security benefits, the give back results in a lower Part B monthly premium. 

Note: Give back benefits are for only Medicare Advantage plans. They are not for original Medicare or Medigap. 

On the surface, it may be confusing why MA plan holders can receive money back, but those with other Medicare plans cannot. 

Unlike Original Medicare, Medicare Advantage plans are run through private companies. That means the government allots a certain amount of money per MA plan holder. If the private company can provide care for less, they can keep the difference as a rebate. 

According to the Medicare Payment Advisory Commission, the rebate on MA plans is $2,350 annually per individual. While some companies use this rebate to fund additional services such as gym memberships, hearing coverage, or foreign healthcare coverage, others refund policyholders in a give back scheme. 

To be eligible for this benefit, someone must first meet Medicare eligibility requirements. Medicare’s website lays out the application steps for those who are 65 and over and get Social Security benefits, as well as those under 65 who get Social Security benefits.

Eligible Medicare recipients through either pathway also qualify for Medicare Advantage plans, including those offering money back. 

There are three times when someone can enroll in an MA plan:

• Initial enrollment period: a seven-month period that begins three months before someone turns 65 and ends three months after their birthday month.
• Open enrollment period: if someone doesn’t already have a Medicare Advantage plan, they can enroll between October 15^th and December 7^th. 
• Medicare Advantage Open Enrollment: if someone does have an MA plan and would like to switch to a different one or enroll in original Medicare, they can do so between January 1^st and March 31^st or in the first three months when they have Medicare.

Note: For more on how to fill out a Medicare application, explore this resource.

How to Get the Medicare Give Back Benefit

Receiving the Medicare give back benefit is simple: look for an MA plan that offers this benefit. When investigating different options, remember that if a company includes a Part B premium refund in one of their policies, it’s not a guarantee they’ll offer it for every plan.

For those who are interested in this option, make sure to ask a licensed Medicare insurance agent or a private company if a specific policy offers this benefit and how much of a rebate the plan provides.

When looking for retirement planning tips Medicare should be a primary concern, and selecting health coverage requires research and reflection. 

As someone compares plans, it’s important to consider:

• Budget: research the premiums, copays, deductibles, and give back benefits outlined in the plan matter, as well as any out-of-pocket costs someone may expect to pay.
• Part D: not all plans cover Plan D. If covering prescription drug costs is important, research plans with Part D included.
• Providers: some plans have a small number of in-network providers while others allow policyholders to go to any Medicare-approved doctor or hospital. 
• Primary care: certain MA plans require policyholders to choose a primary care doctor from a set list of approved practices while others do not.
• Referrals: some MA policyholders need a referral from a primary care provider before they can see a specialist.

Note: For more on different MA plan types, check out this resource.

How to Select a Plan

Researching available plans is a great first step, but no one has to decide on an MA plan alone. There are multiple resources available to answer any questions:

• State Health Insurance Assistance Program (SHIP): this organization organizes local counseling and assistance programs for those selecting a Medicare plan.
• 1–800-MEDICARE: Medicare offers an official talk and live chat feature that is available 24/7, except on federal holidays.
• Companies and agents: for questions on specific plans, contact insurance agencies directly or consult a licensed insurance agents.
• Ask friends and family: for questions about customer satisfaction, and not for a professional interpretation of benefits and costs, turn to those you know. 

Note: Licensed agents follow the marketing rules set out by Medicare. They will never reach out to an individual first or come to someone’s home uninvited.

While the Medicare give back benefit can make Part B more affordable, it’s one of many considerations when choosing a plan, and it doesn’t necessarily mean the overall plan will be cost-effective.

For example, a plan could offer a money back benefit but also charge high copays for seeing the doctor. These plans can also be more restrictive and have fewer doctors and hospitals listed as in-network providers. 

When comparing plans, individuals should explore all costs, benefits, and in-network doctors instead of focusing on one specific trait, such as a give back benefit. The Medicare plan comparison tool is a handy resource to get a holistic look.

If someone has difficulty paying monthly premiums and copays, other options may work better than the Medicare give back benefit. For help paying prescription costs, the Social Security Administration has set up the Medicare Part D Extra Help program, which lowers or cuts Part D costs for those with limited income. 

Medicare savings programs can also help individuals who can’t afford Parts A and B. Typically, these programs are run through the state government and eligibility requirements vary by state. If someone meets a state’s financial requirements, they may not have to pay Medicare coverage costs related to parts A and B.

Can you really get money back from Medicare?

If someone has a Medicare Advantage plan, it is possible to get part of their Part B Premium back, either in the form of a lower monthly bill or a higher monthly social security check.

Can I go back from Medicare Advantage to Medicare?

Switching from Medicare Advantage to Original Medicare and vice versa is possible during two separate periods. The first is the three months after someone selects their initial plan. The other is the annual open enrollment period (October 15th to December 7th for those with Original Medicare and January 1st and March 31st for those with an MA plan).

What is a Medicare supplement plan?

A Medicare supplement plan, also known as Medigap, covers deductibles, copays, and other expenses that Original Medicare does not. Often, these Medicare plans offer additional benefits, like hearing or dental services. There are ten Medigap plan types defined by the states and the federal government, and these plans are independent of Medicare Advantage.

What is a premium refund?

A premium refund is when someone gets a portion of a Medicare premium back. Usually, this applies to the Part B premium and is a perk for select Medicare Advantage plans.