Do I still pay my Medicare Part B premium if I enrolled in a Medicare Advantage plan with a $0 premium?
Yes. A requirement for joining any Medicare
Advantage plan is that you have both Medicare Part A and Medicare Part B
coverage. So if you join a Medicare Advantage plan you must continue to pay your monthly Medicare Part B premiums - even if you join a Medicare Advantage plan with a $0 premium.
Annual changes in Medicare Part B premiums and Hold Harmless clause
The Medicare Part B premium can change each year, but the changes may not affect you. Social Security and the Centers for Medicare & Medicaid Services work together to ensure that the increase in your Medicare Part B premium will not reduce your Social Security benefits.
Per Social Security,
"A special rule called the “hold harmless provision” protects your Social
Security benefit payment from decreasing due to an increase in the
Medicare Part B premium...
Most people with Medicare will pay the new premium amount because the
increase in their benefit amount will cover the increase. However, a
small number of people will see little or no increase in their Part B
premium — and their Social Security benefit checks will remain the same —
because the amount of their cost-of-living adjustment isn’t large
enough to cover the increase."
If you are not affected by the monthly Part B premium increases, you are said to fall under the "Hold Harmless" clause. The "Hold Harmless" clause states that your Medicare Part B premium cannot increase more than your COLA increase -- so that you are effectively paying the same amount each year because your COLA increase will at least cover your Medicare Part B premium increase.
Medicare Part B beneficiaries NOT protected under the "hold harmless" provision are:
- people not collecting Social Security benefits,
- people who are enrolling in Part B for the first time in that year,
- dual eligible Medicare/Medicaid beneficiaries who have their premiums paid by Medicaid, and
- Medicare beneficiaries who pay an additional income-related premium (IRMAA).
According to Social Security, most people do NOT fall under the "hold harmless" provision.
As an example, in 2025, the Medicare Part B premium is
$185.00
for most people. But, for people who are fall under the "hold harmless" provision, the Medicare Part B premium will be $174.70 or less depending on their previous Part B premium.
Source:
https://blog.ssa.gov/ how-the-hold-harmless- provision-protects-your-benefits/