Is a $0 Premium PPO Plan Too Good To Be True?

If you're a senior or someone new to Medicare, you've probably heard about Medicare Advantage plans. These plans are a popular way to get your healthcare coverage, and a lot of them offer something that sounds almost too good to be true: a $0 premium plan.

But what does that really mean? And is a $0 premium Medicare Advantage plan a good choice for you? Let's break it down so you can feel confident when you're looking for an affordable Medicare plan in 2026.

How Can a Medicare Advantage Plan Have a $0 Premium?

It's a great question. When you choose a Medicare Advantage plan (also known as Part C), the government pays the private insurance company a set amount of money each month to provide you with your Part A and Part B benefits. Insurance companies then offer plans to you, the member, that is covered by this financial support. 

So what does that mean to you? You still need to pay your monthly Medicare Part B premium to the government, as this applies to anyone who received Medicare benefits. But, you don’t need to pay any additional monthly premium to get the benefits that a $0 premium plan offers you. To learn more read our blog Are MedicareAdvantage Plans "Free"?

What's Included in a $0 PPO Premium Plan?

Don't think that a $0 premium means you're getting less. Most of these plans offer great Medicare benefits. In fact, the majority of Medicare Advantage plans also include Medicare Part D prescription drug coverage. This is a big plus because Part D on its own is a separate cost. By choosing a Medicare Advantage plan that includes it, you could save a lot of money each year. 

On top of that, plans like Clover Health come with extra benefits, some of which Original Medicare doesn't cover. Here are a few extras we offer at Clover:

• Low Copays: You won’t have to pay a lot when you see your doctor.
• No Referrals: You can see specialists without needing a referral first.
• OTC Allowances: Get money to spend on everyday health items like bandages, pain relievers and vitamins.
• Fitness Benefit: Stay active with a fitness membership.
• Dental, Hearing, and Vision: We offer benefits that cover more than just your basic health needs.

Need even more of a reason to consider these plans? Clover offers $0 Premium PPO plans. With a PPO, you have the freedom to see doctors in or out of network, as long as they accept Clover. To learn more about the differences between a PPO and an HMO, see our blog, "The Advantages of Medicare PPO Plans."

Is a $0 Premium PPO Plan the Right Choice for You?

A $0 premium PPO Medicare Advantage plan can be a great option, especially if you're looking for a plan that helps you save money on your monthly bills while giving you wellness extras that go beyond your basic health needs. As you shop for plans, some other things to consider are:

• Your Doctors: Do you want the freedom to see any doctor*, or are you comfortable with a network? Also, will you need a referral for specialists?
• Your Prescriptions: Does the plan's list of covered drugs (called a formulary) include your medications?
• Your Total Costs: While the monthly premium might be $0, you should also look at copays and deductibles.

If you're looking for a new plan, Clover Health might be a great option for you. We offer plans that are designed to be simple, affordable, and full of benefits.

See what a Clover Health Medicare Advantage Plan in New Jersey, Georgia, Texas, South Carolina, and Pennsylvania has to offer: Click here to learn more.

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*Out-of-network/non-contracted providers are under no obligation to treat Clover members, except in emergency situations.

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