2021 Medicare Costs: Parts A, B, C, D and Medigap

There are 4 primary parts of Medicare, which include some private Medicare policy options. Another type of private Medicare policy is Medicare Supplement Insurance (also called Medigap).

In this guide, we detail the 2021 Medicare costs for each of the following types of Medicare coverage:

• Medicare Part A costs
• Medicare Part B costs
• Medicare Part C (Medicare Advantage) costs
• Medicare Part D prescription drug plans costs
• Medicare Supplement Insurance (Medigap) costs

2021 Medicare costs at a glance

There are several types of costs that may be associated with each type of Medicare plan.

• Premium
  A Medicare premium is the amount that you pay in order to maintain your coverage. Medicare premiums are often paid on a monthly basis.
  
  
• Deductible
  Your Medicare deductible is the amount that you must pay out of pocket for covered services before your Medicare coverage kicks in.
  
  
• Coinsurance
  Coinsurance is the percentage of your healthcare charges that you pay once your deductible is met (example: 20 percent).
  
  
• Copayments
  Copayments are specific amounts you pay for a healthcare service after your deductible is met (example: $20).

Depending on the type of Medicare coverage you have, there may be other costs that you could potentially face. Keep reading to learn more.

Medicare Part A costs in 2021

Medicare Part A is known as hospital insurance and helps cover: 

• Hospital care
• Hospice
• Limited home health services
• Skilled nursing facility care

Part A premiums

Most people do not pay a premium for Medicare Part A, as long as they or or their spouse paid sufficient Medicare taxes while working.

• If you paid Medicare taxes for at least 40 quarters (10 years), you do not have to pay a premium for Part A.
  
  
• If you paid Medicare taxes for between 30 and 39 quarters, you will pay a premium of $259 per month in 2021 for Part A coverage.
  
  
• If you paid Medicare taxes for fewer than 30 quarters, your monthly Part A premium will be $471 in 2021.

Part A deductible

Your Part A deductible is the amount you must pay in hospital costs before Medicare begins paying its share.

In 2021, the Part A deductible is $1,484 per benefit period.

Medicare Part A benefit periods are based on how long you’ve been discharged from the hospital:

• A benefit period begins on the day you're admitted for inpatient care at a hospital, skilled nursing facility or other Medicare-approved facility.
  
  
• Your benefit period resets when you’ve been out of the hospital for 60 days.
  
  
• If you return to the hospital for another visit after 60 days has past, you would have to pay the Part A deductible again because your benefit period reset. 

Part A coinsurance for hospital stays

After you meet your Part A deductible in a benefit period, you will be responsible for daily coinsurance payments for as long as you remain hospitalized:

• For your first 60 days that you are in the hospital, you pay nothing additional out of pocket for your hospital costs after meeting your $1,484 deductible.
 
• For days 61-90 in a hospital during a single benefit period, you pay a $371 coinsurance in 2021 for each day you are hospitalized.
 
• If you are in the hospital for more than 90 days during a single benefit period, you pay a $742 coinsurance in 2021 for each day you are hospitalized, for up to 60 lifetime reserve days.

Part A coinsurance for skilled nursing facility care

Medicare Part A covers skilled nursing care provided in a skilled nursing facility under certain circumstances. The 2021 Part A coinsurance amounts are as follows:

• Days 1-20: $0 coinsurance per benefit period
  
  
• Days 21-100: $185.50 coinsurance per day of each benefit period
  
  
• Days 101 and beyond: You are responsible for all costs

Medicare Part B costs in 2021

Medicare Part B is known as medical insurance and helps cover preventive services and medically necessary services that include (but aren't limited to):

• Clinical research
• Doctor’s services
• Ambulance services
• Limited outpatient prescription drugs
• Getting a second opinion before surgery
• Durable medical equipment (DME)

Part B premiums

In 2021, the standard Medicare Part B premium is $148.50 per month.

Most people pay the standard premium amount, but your Part B premium could be higher depending on your income. Some people who get Social Security benefits may pay less.

In 2021, individuals with reported 2019 incomes of more than $88,000 and married couples with reported 2019 incomes of greater than $176,000 have to pay more for their Part B coverage.

This increased amount is called the Medicare IRMAA, or the Income-Related Monthly Adjustment Amount.

The chart below shows what you will pay for your Part B premium in 2021 based on your modified adjusted gross income from two years prior (2019).

Medicare Part B IRMAA

2019 Individual tax return	2019 Joint tax return	2019 Married and separate tax return	2021 Part B monthly premium
$88,000 or less	$176,000 or less	$88,000 or less	$148.50
More than $88,000 and up to $111,000	More than $176,000 and up to $222,000	N/A	$207.90
More than $111,000 up to $138,000	More than $222,000 up to $276,000	N/A	$297.00
More than $138,000 up to $165,000	More than $276,000 up to $330,000	N/A	$386.10
More than $165,000 up to $500,000	More than $330,000 up to $750,000	More than $88,000 up to $412,000	$475.20
More than or equal to $500,000	More than or equal to $750,000	More than or equal to $412,000	$504.90

Part B deductible

Your Part B deductible is the amount you must pay in medical costs before Medicare begins paying its share.

In 2021, the Part B deductible is $203 per year.

Part B coinsurance/copayment

After you meet your Part B deductible, you typically pay 20 percent of the Medicare-approved amount for most doctor’s services.

Part B excess charges

Doctors who do not accept Medicare assignment can charge more than the Medicare-approved amount for a service or procedure. The difference between the amount a doctor charges and the Medicare-approved amount is known as an excess charge.

The Part B excess charge can be as much as 15 percent more than the Medicare-approved amount.

2021 Medicare Advantage (Part C) costs

Medicare Advantage (Medicare Part C) is an alternative to Original Medicare that provides the same benefits as Medicare Part A and Part B.

• Many Medicare Advantage plans may cover prescription drugs. 
  
  
• Some Medicare Advantage plans also offer coverage for vision, dental and hearing, as well as health and wellness programs such as SilverSneakers to help keep enrollees active and healthy.
  
  
• Some Medicare Advantage plans may offer additional benefits such as transportation to doctor's appointments, grab bars in home bathrooms and healthy meals delivered to your home.

Original Medicare does not cover vision, dental or hearing services that are not considered medically necessary. This includes routine and preventive care.

If you’re enrolled in Original Medicare, you are responsible for 100 percent of the costs related to these services.

If your Medicare Advantage plan includes coverage for prescription drugs, you typically pay a coinsurance or copayment for covered drugs. With Original Medicare, you could pay 100 percent of the costs of many prescription drugs.

Specific prescription drug costs will vary depending on the Medicare Advantage plan you enroll in.

Medicare Advantage out-of-pocket maximum

Medicare Advantage have an out-of-pocket maximum, which limits how much you could pay out of pocket for care in a given year. Original Medicare does not have an out-of-pocket maximum.

The following chart shows how Medicare Advantage coverage and benefits compare to those of Original Medicare.

Original Medicare vs. Medicare Advantage

	Original Medicare	Medicare Advantage
Helps cover hospital and medical costs	✔	✔
May cover routine dental care	✘	✔
May cover routine vision care	✘	✔
May cover prescription drugs	✘	✔
Has an out of pocket maximum	✘	✔

Medicare Advantage premiums

Because Medicare Advantage plans are sold by private insurance companies, there is no standard premium like there is with Original Medicare. Premiums may vary according to plan, insurance carrier and location. 

In 2021, the average monthly premium for a Medicare Advantage plan that includes prescription drug coverage is around $33 per month.¹

Depending on where you live, there may be Medicare Advantage plans available that feature $0 premiums. 

According to Medicare expert John Barkett, Medicare Advantage premiums dropped by around 14 percent in 2020. Hear more about this in the video below.

Medicare Advantage deductibles

Deductibles for Medicare Advantage plans can vary.

In 2021, the average weighted drug deductible for a Medicare Advantage plan with prescription drug coverage is around $167 per year.¹

Some Medicare Advantage plans may feature $0 deductibles.

2021 Medicare Part D costs

Original Medicare does not generally cover prescription drugs, with the exception of limited outpatient prescription drugs.

If you want Medicare prescription drug coverage, you can enroll in a Medicare Advantage plan that includes drug coverage, or you can enroll in a stand-alone Part D (Medicare Prescription Drug Plan) plan.

Compare Part D plans available where you live and enroll in a Medicare prescription drug plan online in as little as 10 minutes when you visit MyRxPlans.com.²

Part D premiums

If you enroll in a Medicare Part D plan, you typically pay a monthly premium for your Part D coverage in addition to your Medicare Part B and Medicare Advantage premiums (if applicable).

Part D premiums will differ from one plan, carrier or location to another.

The average premium paid for a Part D plan in 2021 is about $41 per month.¹

Some Part D plans may feature $0 deductibles.

As with Medicare Part B, some people who earn a higher income may pay a higher premium for their Part D plan. This increased amount is called the Income-Related Monthly Adjustment Amount (IRMA).

The table below shows what you can expect to pay for your 2021 Part D premiums based on your reported income in 2019.

Medicare Part D IRMAA

2019 Individual tax return	2019 Joint tax return	2019 Married and separate tax return	2021 Part D monthly premium
$88,000 or less	$176,000 or less	$88,000 or less	Your plan premium
More than $88,000 and up to $111,000	More than $176,000 and up to $222,000	N/A	$12.30 + your plan premium
More than $111,000 up to $138,000	More than $222,000 up to $276,000	N/A	$31.80 + your plan premium
More than $138,000 up to $165,000	More than $276,000 up to $330,000	N/A	$51.20 + your plan premium
More than $165,000 up to $500,000	More than $330,000 up to $750,000	More than $88,000 up to $412,000	$70.70 + your plan premium
More than or equal to $500,000	More than or equal to $750,000	More than or equal to $412,000	$77.10 + your plan premium

Part D deductibles

Part D deductibles may vary from one plan to the next.

The maximum allowed annual Part D plan deductible in 2021 is $445. Some Part D plans may offer $0 deductibles for certain drugs.

Part D coinsurance/copayments

Medicare Part D plans include a drug formulary, which is a list of what drugs the plan may cover.

Medicare plan formularies are divided into tiers. Formulary tiers correspond to how much you might pay in coinsurance or copayments for specific drugs (after you meet your Part D deductible):

• Low-cost, generic drugs are typically on lower tiers.
• More expensive and brand name drugs are typically on higher tiers.

Part D donut hole

Medicare Part D plans have a coverage gap, or “donut hole,” which is a temporary limit on how much a Prescription Drug Plan will pay for prescription drug costs. In 2020, the donut hole closed.

Here’s how the Part D donut hole works:

• Part D plans have an Initial Coverage Limit ($4,130 in 2021), which is the total amount you and your plan can spend on prescription drugs before entering your plan’s coverage gap.
 
• Once you enter the "donut hole" coverage gap, you pay 25 percent of the cost for your covered name brand drugs and generic prescription drugs.
 
• Once you spend $6,550 on prescription drugs in 2021, you will leave the coverage gap and enter catastrophic coverage.
 
• The costs you pay for drugs while in the coverage gap typically contribute to your $6,550 out of pocket total to help get you out of the coverage gap.
 
• With catastrophic coverage, you pay a smaller copayment or coinsurance than you did during the initial coverage phase or while you were in the coverage gap.
 
• Catastrophic coverage remains in effect until the end of the year.

2021 Medicare Supplement Insurance (Medigap) costs

Medicare Supplement Insurance, or Medigap, helps cover some of the out-of-pocket costs that Medicare Part A and Part B don't cover, such as deductibles, coinsurance and copayments.

There are 10 different types of standardized Medigap plans available in most states. The types of costs that different types of Medigap plans are illustrated in the Medigap plans comparison chart below. 

Foreign travel emergency costs

Original Medicare does not typically cover healthcare services received outside of the U.S. and its territories. This means that you are generally responsible for 100 percent of your health care costs while traveling abroad.

Listed below are three exceptions to this rule.

• You’re in the United States when you have a medical emergency and a foreign hospital is closer than the nearest U.S. hospital.
 
• You live in the United States and a foreign hospital is closer to your home than the nearest U.S. hospital that can treat you for your medical condition.
 
• You’re traveling through Canada “without reasonable delay” by the most direct route between Alaska and another state when a medical emergency occurs and the Canadian hospital is closer than the nearest U.S. hospital.

If you have a Medigap plan that helps cover foreign travel emergency costs, however, you could get help covering some of the costs that Original Medicare would not otherwise typically pay.

Medicare Advantage eligibility and enrollment

Once you’re enrolled in Medicare Part A and Part B, you may be able to enroll in a Medicare Advantage plan.

Speak with a licensed insurance agent to learn more about your options and to compare Medicare Advantage plans in your area.

¹ MedicareAdvantage.com's The Best States for Medicare in 2021 report. (Oct. 27, 2020).

² 10-minute claim is based solely on the time to complete the e-application if you have your Medicare card and other pertinent information available when you apply. The time to shop for plans, compare rates, and estimate drug costs is not factored into the claim. Application time could be longer. Actual time to enroll will depend on the consumer and their plan comparison needs.