Easy Point After or Hail Mary? What Medicare Advantage's Part B Giveback Really Gets You
A Medicare Advantage plan that puts an extra $2,400 a year in your pocket sounds like an easy decision. Too good to be true? Sort of.
The catch is that the biggest giveback does not mean the best plan. Some of the plans offering the largest givebacks have no prescription drug coverage at all. Others come with out-of-pocket maximums approaching $10,000. And some are sold in only a handful of counties.
The giveback itself is an easy point after: a genuine benefit that raises your Social Security payment or lowers the Part B premium you owe. But choosing a Medicare Advantage plan on that benefit alone is a Hail Mary.
Here's how it works, which plans give back the most in the ten most populous states, and what to check before you call it a win.
What a Part B giveback actually is
Most of us on Medicare pay a monthly premium for Part B, the half of Medicare that covers doctors and outpatient care. In 2026 the standard premium is $202.90 a month, and for most people Social Security takes it straight out of their payment before it arrives.
A Part B giveback (also called a premium reduction or a Part B buy-down) is a Medicare Advantage plan agreeing to pay part of that premium for you. You do not get a check from the insurance company. Social Security simply takes less out. A plan giving back $100 a month means your deposit grows by $100, starting a month or two after your coverage does.
It is also easy. Once you enroll in a plan with a giveback, there is no additional paperwork. No reimbursement forms. No receipts. No spending requirements.
Unlike a dental allowance, which you have to spend at a dentist to get any value from, a giveback puts money back in your pocket without requiring you to buy anything.
That's a real benefit. But don't spike the football just yet.
The other side of the ball: what you give up
A Medicare Advantage plan has to balance its benefits, costs and other features. A larger giveback may come with trade-offs elsewhere in the plan. Every dollar devoted to one benefit is a dollar that isn't available for another. The relationship isn't a simple dollar-for-dollar exchange, but the practical point stands: judge the whole plan, not the giveback.
Pro Tip: Keep in mind that a Medicare Advantage plan can reduce the giveback next year. The plan with the Part B giveback could even be eliminated. There's no guarantee that the plan you choose in 2027 will be the same plan in 2028.
Look at the table below. Several of the plans with the largest givebacks have no prescription drug coverage, or an out-of-pocket maximum approaching $10,000. Those details matter far more if you take expensive medications, see specialists often, or spend time in a hospital.
Who it is worth less to than it looks. Three cases:
- Medicaid already pays your Part B premium. If you have full Medicaid, or qualify for one of the Medicare Savings Programs, your state is already paying that premium. A plan "giving it back" gives it back to the state, not to you. This one is worth nothing.
- You are not yet drawing Social Security. You still get the benefit, but as a smaller Part B bill rather than a bigger deposit — same money, less visible.
- You pay an income-related surcharge (IRMAA). You still get the benefit, but it comes off the standard premium, not the surcharge on top of it. Ask the plan what your actual deduction becomes.
It is not a reason on its own to switch. A $150 giveback is $1,800 a year. One bad year can cost more than that several times over: a hospital stay or an infused cancer drug can take you all the way to the plan's out-of-pocket maximum, and the gap between a $9,850 maximum and a $3,400 one is $6,450 — more than three times the giveback.
The 2027 numbers
For 2027, 1,413 Medicare Advantage plans filed a Part B giveback with Medicare. The amounts run from a token 10 cents a month to the full $202.90, and the middle of the pack is $90 a month. Fifty-three plans give back the whole $202.90, which is the entire standard premium as it stands today.
Below is the largest giveback in each of the ten most populous states, counting only plans anyone on Medicare can join — not special needs plans, which require Medicaid or a specific diagnosis.
| State | Plan | Giveback | A year | What you give up |
|---|---|---|---|---|
| California | Alignment Health Smart 055 (HMO) | $197.00 | $2,364 | Los Angeles County only |
| Texas | Prominence Giveback (HMO) | $202.90 | $2,435 | 8 counties; $7,500 out-of-pocket maximum |
| Florida | Optimum Gold Rewards Plan (HMO) | $202.90 | $2,435 | 6 counties; one of 17 Florida plans tied at the maximum |
| New York | AARP Medicare Advantage Patriot No Rx NY-MA3 (HMO-POS) | $125.00 | $1,500 | No drug coverage |
| Pennsylvania | AARP Medicare Advantage Patriot No Rx PA-MA01 (HMO-POS) | $200.00 | $2,400 | No drug coverage |
| Illinois | Devoted Choice Giveback 002 IL (PPO) | $184.70 | $2,216 | $9,850 out-of-pocket maximum |
| Ohio | AARP Medicare Advantage Patriot No Rx OH-MA2 (HMO-POS) | $200.00 | $2,400 | No drug coverage |
| Georgia | Devoted Choice MA Only 003 GA (PPO) | $184.70 | $2,216 | No drug coverage |
| North Carolina | Devoted Giveback 012 NC (HMO) | $195.00 | $2,340 | 14 counties; $9,850 out-of-pocket maximum |
| Michigan | Devoted Choice Giveback 006 MI (PPO) | $152.00 | $1,824 | 3 counties; $9,850 out-of-pocket maximum |
Three things to check before you call it a win
Check the playing field: your county matters. California's biggest giveback is sold in Los Angeles County and nowhere else. Michigan's is sold in three counties out of 83. The Pennsylvania and Ohio plans, by contrast, are sold in every county in the state. A plan you cannot buy is not an option, however good the number.
Check the standings: some states have ties. Seventeen Florida plans give back the full $202.90; the one listed is simply the one sold in the most counties. In Illinois, Ohio, Georgia, New York and Michigan the leader is tied with at least one other plan too. Treat the table as "the most you can get", not "the plan you should buy".
Read the whole playbook: the headline benefit isn't the whole package. Eight of these ten either drop drug coverage or carry an out-of-pocket maximum above $7,000. Only the California and Florida leaders do neither.
And be careful with the four that have no drug coverage. You cannot keep one of these plans and add a standalone Part D drug plan alongside it: Medicare's rule is that joining a separate drug plan drops you out of your Medicare Advantage HMO or PPO and returns you to Original Medicare — and the giveback goes with it. Plans like these are built for people who already have drug coverage somewhere else, such as the VA, TRICARE, or a retiree plan from an employer or union. If that isn't you, a no-drug plan is the wrong plan, whatever it gives back.
Before you switch sides for the money
Before enrolling in a plan because of its giveback, work through these questions in order:
- Is the plan sold where I live? Check your county, not just your state, on our comparison tool.
- Are my doctors on this roster? Call the office and ask, by plan name.
- What happens if I get hurt? Find the in-network out-of-pocket maximum and the rest of the cost sharing, and compare it with what you have now.
- Where will my prescriptions come from? If the plan has no drug coverage, you need another source — the VA, TRICARE, or retiree coverage. You cannot bolt a Part D plan onto it, and going without creditable drug coverage can cost you a late enrollment penalty later.
Our comparison grid shows the premium, the Part B giveback, the out-of-pocket maximum and the drug costs for every plan sold in your county, side by side. Medicare's own Plan Finder is the official source and the place to enroll, and your state's SHIP counselor will go through it all with you for free. Open enrollment runs from October 15 to December 7.
Figures are from Medicare's published 2027 plan benefit filings and the September 2026 CY2027 landscape files. The 2026 Part B premium of $202.90 and the $283 deductible are from CMS.