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 can vary wildly, and 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 2020, premiums typically break down as follows:
Part A premium
This covers more expensive, long-term, and specialized healthcare needs, such as hospital in-patient stays, the costs of nursing homes and hospice, and sometimes in-home care.
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 $458 each month in 2020. If you paid Medicare taxes for less than 30 quarters, the standard Part A premium is $458. If you paid Medicare taxes for 30-39 quarters, the standard Part A premium is $252.
Part A Hospital Inpatient Deductible and Coinsurance
- $1,408 deductible for each benefit period
- Days 1-60: $0 coinsurance for each benefit period
- Days 61-90: $352 coinsurance per day of each benefit period
- Days 91 and beyond: $704 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. 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 $144.60 (or higher depending on your income).
Part B Deductible and Coinsurance
$198. 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 is similar to a Medigap plan, but it includes a prescription drug plan and it usually comes at little or no cost (but it’s more limited in terms of doctors and coverage, and can be harder to qualify for). Premiums for Part C are sold in the private marketplace, which means they vary by provider, plan, and location. You can check Medicare.gov to Compare costs for specific Part C plans.
Part D Premium
This covers prescription drugs, as well as 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 providers. This means the premiums will vary plan to plan. In order to qualify for Medicare Part D, you will also need to enroll in a Medicare-approved plan. That being said, all plans come with a standard amount of 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 an insurance specialist today.