What Can I Expect To Pay For Medicare?

While some people may be under the impression that Medicare is free for everyone who qualifies, this isn’t true.  Medicare is usually less expensive than regular insurance, but there are still premiums to pay. The cost of premiums fluctuate from year to year.  

Medicare is broken down into Parts:  A, B, C, and D.  Medicare.gov has updated their prices and estimates, although they do warn that these are not firm guaranteed prices.  Rather, they are an estimate for what you may expect to pay.  According to Medicare.gov, as of 2022, premiums typically break down as follows: 

Part A premium

This covers short-term in-patient hospital stays, specialized healthcare needs, hospice, and sometimes in-home care. Nursing home coverage is not long-term but rather a short-term rehab facility after an injury or illness. 

Most people don’t pay a monthly premium for Part A (sometimes called “premium-free Part A”). If you buy Part A, you’ll pay up to $499 each month in 2022. If you paid Medicare taxes for less than 30 quarters, the standard Part A premium is $499. If you paid Medicare taxes for 30-39 quarters, the standard Part A premium is $274.

Part A Hospital Inpatient Deductible and Coinsurance

You pay:

• $1,556 deductible for each benefit period
• Days 1-60: $0 coinsurance for each benefit period after you pay your Part A deductible
• Days 61-90: $389 coinsurance per day of each benefit period
• Days 91 and beyond: $778 coinsurance per each “lifetime reserve day” after day 90 for each benefit period (up to 60 days over your lifetime)
• Beyond lifetime reserve days: all costs

Part B Premium

Medicare Part B covers more routine care, such as doctors’ services, medical supplies, check ups, outpatient services, and preventative care as well as some specialized care such as specialty doctor outpatient visits.  Everyone is subject to a premium of some kind for Part B.  While Medicare Part B is optional, you are likely to be enrolled automatically if you are auto-enrolled in Part A, but you have the option to drop it. 

The standard Part B premium amount is $170.10 (or higher depending on your income).

Part B Deductible and Coinsurance

$233. After your deductible is met, you typically pay 20% of the Medicare-approved amount for most doctor services (including most doctor services while you’re a hospital inpatient), outpatient therapy, and durable medical equipment (DME).

Part C Premium

Medicare part C is a bit different, as it’s a Medicare Advantage plan. Medicare Part C may include a prescription drug plan and it usually comes at little or no premium (but it may be more limited in terms of doctors and coverage).  Premiums for Part C are sold in the private marketplace which means they vary by plan and location.  Part C premiums may be lower if you receive extra help or a low income subsidy. You can check Medicare.gov to Compare costs for specific Part C plans.

Part D Premium

This covers prescription drugs, as well as some shots and vaccinations.  The Part D monthly premium varies by plan (higher-income consumers may pay more).  Because Medicare Part D strictly covers prescription drugs only, it is sold by private insurance plans.  This means the premiums will vary plan to plan. In order to qualify for Medicare Part D, you will also need to be enrolled in Medicare Part A and/or Part B.  That being said, all Medicare Part D plans come with a standard amount of minimum coverage set by Medicare. 

To get an idea of what your Medicare expenses might be, the Centers for Medicare & Medicaid Services offers an Out-Of-Pocket Cost Calculator.  While this isn’t a definitive guarantee of your actual cost, it can help you prepare for what you might be looking at paying. 

There are so many details and difficulties to enrolling, navigating the system, and keeping up with what plan will be right for you.  Opportunities to save money may go amiss, and certain coverage needs may be overlooked.  Don’t go it alone.  Get a quote and talk to a licensed insurance agent today.