Is Medicare Free? Not Quite.

Some people may make the mistake of thinking that Medicare is free. There are certain instances in which Medicare covers services 100%, but by and large, Medicare is not completely free

Below we’ll outline the 2019 costs for the different parts of Medicare. We’ll also help you identify ways to maximize your coverage while minimizing your costs. 

Depending on where you live and if you’re eligible, you may be able to enroll in a $0 premium Medicare Advantage (Medicare Part C) plan. A licensed insurance agent can help you find $0 premium plans in your area when you call TTY Users: 711, 24/7.

All costs listed below are for 2019.

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2019 Medicare Part A Costs: What is premium-free Part A?

Many people do not pay a premium for their Part A coverage. 

Part A, which provides coverage for inpatient care at hospitals and skilled nursing facilities, comes without a premium for beneficiaries who paid Medicare taxes for 40 quarters or more (the equivalent of 10 full years). 

  • Anyone who only paid Medicare taxes for between 30 and 39 quarters, the monthly premium is $240 in 2019.

  • If you paid Medicare taxes for fewer than 30 quarters, your Part A premium is $437 pre month. 

But the premium is only one Part A cost you may have to pay.

Before your Part A coverage kicks in for an inpatient hospital stay, you must first satisfy a deductible of $1,364 per benefit period.

A benefit period begins the day you are admitted to a hospital or skilled nursing facility as an inpatient and ends when you have not been an inpatient for at least 60 consecutive days.

Theoretically, you could face multiple benefit periods in the same calendar year (and be responsible for paying the Part A deductible for each benefit period). 

If you have an inpatient hospital stay longer than 60 days, you may also have to pay Part A coinsurance costs once you’ve met your deductible:

  • Beginning with day 61 of an inpatient hospital stay, you’ll face a Part A coinsurance payment of $341 per day in 2019.

  • On day 91, you begin to tap into your 60 lifetime reserve days, and they come with a daily coinsurance requirement of $682.

  • Once your 60 lifetime reserve days are exhausted, you’re responsible for all of your hospital costs. You have up to 60 of these to use over your lifetime, and you cannot accumulate more lifetime reserve days after you use them all.

2019 Medicare Part B Costs: What is the Part B premium?

While the cost of Medicare Part A is based on your history of paying taxes, your cost for Medicare Part B depends partly on your income. More specifically, it’s based on your adjusted gross income from two years prior (your 2019 Part B premium is based on your 2017 reported income).  

Most people (individuals with reported incomes of less than $85,000 in 2019 and married couples with combined incomes of less than $170,000) pay the standard Part B premium of $135.50 per month.

Higher income earners are required to pay what is known as IRMAA, or the Income Related Monthly Adjustment Amount.

The chart below shows what beneficiaries of differing incomes pay for their Part B premiums in 2019.

Medicare Part B IRMAA
2017 Individual tax return 2017 Joint tax return 2017 Married and separate tax return 2019 Part B premium
$85,000 or less $170,000 or less $85,000 or less $135.50
More than $85,000 and up to $107,000 More than $170,000 and up to $214,000 N/A $189.60
More than $107,000 up to $133,500 More than $214,000 up to $267,000 N/A $270.90
More than $133,500 up to $160,000 More than $267,000 up to $320,000 N/A $352.20
More than $160,000 up to $500,000 More than $320,000 up to $750,000 More than $85,000 up to $415,000 $433.40
More $500,000 More than $750,000 More than $415,000 $460.50

You are also responsible for paying the annual Part B deductible before your Part B coverage kicks in. In 2019, the Part B deductible is $185 for the entire year. 

After you meet your deductible, you are typically responsible for Part B copayments or coinsurance of 20 percent of the Medicare-approved amount for all covered services and items.

2019 Medicare Part C Costs: Finding $0 premium Medicare Advantage plans

Medicare Part C is also known as Medicare Advantage.

Medicare Advantage plans, sold by private insurance companies, provide all of the same benefits as Original Medicare (Part A and Part B).

Some plans may also include extra coverage for things like prescription drugs, dental, vision, hearing, gym memberships and other things that Original Medicare doesn’t cover.

Each Medicare Advantage plan may also include its own deductibles, coinsurance or copayments.

Because Medicare Advantage plans are sold by private insurance companies, their costs can vary greatly from one location, carrier or plan to another. In 2019, the weighted average premium that was paid for a Medicare Advantage plan was $29 per month.1

Some Medicare Advantage plans may feature with $0 premiums. A licensed insurance agent can help you find $0 premium plans that may be available where you live if you’re eligible to enroll.

Compare Medicare Advantage plans in your area

Compare Plans

Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.

Medicare Part D Costs: Is Medicare prescription drug coverage free?

Medicare Part D plans provide coverage for prescription drugs and are also sold by private insurance companies. The cost of Medicare Part D plans can vary from one plan to another. 

Like Medicare Part B, Part D also charges an IRMAA for higher income earners. The table below displays the amount that beneficiaries of various income levels must pay for their 2019 Medicare Part D premium.

Medicare Part D IRMAA
2017 Individual tax return 2017 Joint tax return 2017 Married and separate tax return 2019 Part D premium

$85,000 or less

$170,000 or less

$85,000 or less

Your plan premium

More than $85,000 and up to $107,000

More than $170,000 and up to $214,000

N/A

You plan premium + $12.40

More than $107,000 up to $133,500

More than $214,000 up to $267,000

N/A

Your plan premium + $31.90

More than $133,500 up to $160,000

More than $267,000 up to $320,000

N/A

Your plan premium + $51.40

More than $160,000 up to $500,000

More than $320,000 up to $750,000

More than $85,000 up to $415,000

Your plan premium + $70.90

More $500,000

More than $750,000

More than $415,000

Your plan premium + $77.40

In 2018, the average premium paid for a Part D plan was $52 per month.1

Deductibles and cost sharing requirements will differ according to each plan. Some Part D plans may feature $0 deductibles and $0 coinsurance or copayments for select drugs from preferred pharmacy providers.

What about Medicare for the disabled?

People under 65 years old who have a qualifying disability may be eligible for Medicare. However, the coverage still requires the same costs as those who qualify based on age, such as certain premiums, deductibles and coinsurance. 

Can you get help paying for Medicare?

There are more than a few ways to get some help paying for your Medicare costs. 

Medicare Supplement Insurance

Medicare Supplement Insurance, also called Medigap, can help cover some of the out-of-pocket costs associated with Medicare Part A and Part B. These can include Medicare deductibles, coinsurance, copayments and other costs.

Medigap plans are sold by private insurance companies, so their premiums may vary. There are 10 standardized Medigap plans available in most states, though, and the benefits these Medigap plans offer are standardized across the country. You cannot have a Medicare Advantage plan and Medicare Supplement Insurance plan at the same time.

Medicare Extra Help

Extra Help, or the Medicare Part D Low-Income Subsidy, is a federal program that helps certain Medicare beneficiaries with limited incomes pay for their Part D coverage.

If you qualify for Medicare Extra help in 2019, you won’t have to pay more than $3.40 for generic drugs that are covered by your plan, or $8.50 for brand name drugs.

Medicare Savings Programs

There are four different types of Medicare Savings Programs (MSP) that can assist beneficiaries with certain Medicare costs, which can include Part A and Part B premiums, deductibles, copayments and coinsurance, depending on which MSP you have. 

Medicaid

State Medicaid programs may be used alongside Medicare to help lower your health care costs.

If you qualify for both Medicare and Medicaid, you are considered dual eligible. Dual eligible beneficiaries may be able to enroll in a Medicare Special Needs Plan (SNP), if any are available in your area.

A Medicare SNP can help provide you with coordinated health care, and all SNPs include prescription drug coverage.

Medicare PACE

Medicare Programs of All-inclusive Care for the Elderly (PACE) is a state assistance program that works with Medicare and Medicaid to provide Part D coverage and a number of community-based care options. 

Find an affordable or $0 premium Medicare Advantage plan

An affordable or $0 premium Medicare Advantage plans may be available where you live. A licensed insurance agent can help you determine your eligibility, compare Medicare Advantage plans that are available near you, and help you find a plan that fits your budget and your coverage needs.

 

Compare Medicare Advantage plans in your area

Compare Plans

Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.

Copyright © 2019 TZ Insurance Solutions LLC. All rights reserved.

1 MedicareAdvantage.com's internal analysis of CMS Medicare Advantage landscape source files, May 2018. Data retrieved from https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovGenIn.

MedicareAdvantage.com is a website owned and operated by TZ Insurance Solutions LLC. TZ Insurance Solutions LLC and TruBridge, Inc. represent Medicare Advantage Organizations and Prescription Drug Plans having Medicare contracts; enrollment in any plan depends upon contract renewal.

Plan availability varies by region and state. For a complete list of available plans, please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.

Medicare has neither reviewed nor endorsed this information.