Do you understand your Medicare costs?

If you’re new to Medicare or approaching Medicare eligibility, you may have questions regarding how much you’ll likely pay for health care coverage once you’re 65.

Medicare Part A and Part B help cover hospital and medical costs, respectively, but they don’t cover everything. Each of these parts have their own out-of-pocket costs.

Monthly premiums

Most people do not pay a monthly premium for Medicare Part A.

The Part B premium is around $134 a month¹, but can vary based on your income and Social Security status.

If you enroll in a Medicare Prescription Drug Plan (Medicare Part D), you’ll pay a monthly premium for coverage. Specific Part D premiums will vary by plan.

Deductibles

Each year, you must meet a Medicare Part B deductible before Medicare begins paying its share of health care costs. In 2018, the Medicare Part B deductible is $183 per year.²

Medicare Part A deductibles are billed per benefit period, not per year. In 2018, the Part A deductible is $1,340 per benefit period.³

A benefit period begins the day you are admitted to the hospital and ends when you’ve been discharged for at least 60 days. If you have been out of the hospital for more than 60 days and are admitted again, a new benefit period begins.

Coinsurance

Coinsurance is how much you must pay for a service after your deductible is met. Prior to your deductible being met, you are responsible for 100% of the costs.

Medicare Part A coinsurance: ⁴ 

• Days 1-60: $0 coinsurance for each benefit period
• Days 61-90: $335 coinsurance for day of each benefit period
• Days 91 and beyond: $670 coinsurance per each “lifetime reserve day” after day 90 for each benefit period (up to 60 days over your lifetime)
• Beyond lifetime reserve days: you’re responsible for 100% of costs

Medicare Part B coinsurance

Once your deductible is paid, you typically pay 20% of the Medicare-approved amount for most doctor services and Medicare pays 80%.

Could Medicare Advantage save you money?

As a Medicare beneficiary, you may have the option to enroll in Medicare Advantage, which provides at least the same benefits as Original Medicare, but may also cover: 

• Prescription drugs
• Vision care
• Dental care
• Wellness programs

Medicare Advantage Costs

Your Medicare Advantage deductibles, coinsurance and copayments will vary depending on the plan you choose.

You must pay your Medicare Part B premium in addition to your Medicare Advantage premium (if your plan has one).⁵

Speak with a licensed insurance agent

A licensed insurance agent can help you better understand your monthly Medicare costs and help you choose an option that works for you. Speak with an agent now at 1-855-710-8630, TTY: 711.

¹https://www.medicare.gov/your-medicare-costs/costs-at-a-glance/costs-at-glance.html
²https://www.medicare.gov/your-medicare-costs/costs-at-a-glance/costs-at-glance.html
³https://www.medicare.gov/your-medicare-costs/costs-at-a-glance/costs-at-glance.html
⁴https://www.medicare.gov/your-medicare-costs/costs-at-a-glance/costs-at-glance.html
⁵*You must continue to pay your Part B premium. $0 premiums may not be available in all areas.