The Average Cost of Medicare in 2019

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How much does Medicare cost in 2019? It’s a simple question with a complex set of answers.

This guide details the average costs of each part of Medicare in 2019. This includes:

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What will Medicare Part A cost in 2019?

Medicare Part A is hospital insurance. It covers some of your costs when you are admitted for inpatient care at a hospital, skilled nursing facility and some other types of inpatient facilities.

Part A can include a number of costs, including premiums, a deductible and coinsurance.

2019 Part A premiums

There are two important things to keep in mind about Part A premiums:

  • Most people qualify for premium-free Part A.
    To qualify for premium-free Part A, you or your spouse must have worked and paid Medicare taxes for the equivalent of 10 years (40 quarters). Those 40 quarters do not have to be consecutive.

  • If you pay a premium for Part A, your premium could be up to $437 per month in 2019.
    If you paid Medicare taxes for only 30-39 quarters, your 2019 Part A premium will be $240 per month. If you paid Medicare taxes for fewer than 30 quarters, your premium will be $437 per month.

2019 Part A deductible

If you are admitted to a hospital for inpatient treatment, Medicare Part A helps cover your hospital costs once you reach your Medicare Part A deductible. The Part A deductible is $1,364 per benefit period in 2019.

The Medicare Part A deductible is not annual — you could potentially need to meet this deductible more than once in a given year.

2019 Part A coinsurance

After you meet your Part A deductible, you may be required to pay Part A coinsurance for extended hospital stays.

For the first 60 days of your hospital stay, you aren’t required to pay Part A coinsurance.

But beginning on day 61 of your stay in 2019, you’re required to make a Medicare Part A coinsurance payment of $341 per day through day 90. After your 90th day in the hospital, you must pay $682 per day for up to 60 more days in 2019.

Those 60 “lifetime reserve days” do not reset annually. They can only be used once.

Beyond that, you are responsible for all costs.

Part A also requires coinsurance for hospice care and skilled nursing facility care.

  • Part A hospice care coinsurance or copayment
    Medicare Part A requires a copayment for prescription drugs used during hospice care. You might also be charged a 5 percent coinsurance for inpatient respite care costs.

  • Skilled nursing facility care coinsurance
    Medicare Part A requires a coinsurance payment of $170.50 per day in 2019 for inpatient skilled nursing facility stays longer than 20 days. You are responsible for all costs after day 101 of an inpatient skilled nursing facility stay.

    Skilled nursing care is based on benefit periods like inpatient hospital stays.

What is the cost of Medicare Part B for 2019?

Medicare Part B covers medical insurance benefits and includes monthly premiums, an annual deductible, coinsurance and other potential costs.

2019 Part B premiums

The standard monthly premium for Medicare Part B is $135.50 per month in 2019.

Some Medicare beneficiaries may pay more or less per month for their Part B coverage. The Part B premium is based on your reported income from two years ago (2017).

People who had higher income in 2017 may pay higher Part B premiums, which is called the IRMAA (Income-related Monthly Adjustment Amount).

The 2019 Part B premium breakdown is below.

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

2019 Part B deductible

You must meet your Part B deductible before Part B pays its share of most covered services (the deductible doesn’t apply to certain preventative services), for example:

The 2019 Part B deductible is $185 per year.

2019 Part B coinsurance or copayment

Once you meet your Part B deductible for the year, you typically pay 20 percent of the Medicare-approved amount for services that are covered by Part B.

Part B late enrollment penalty

If you don’t sign up for Medicare Part B when you’re first eligible, you may be required to pay a late enrollment penalty.

The Part B late enrollment penalty is as much as 10 percent of the Part B premium for each 12-month period that you were eligible to enroll but did not.

For example, if you waited three years after your Initial Enrollment Period to sign up for Medicare Part B, your late enrollment penalty could be 30 percent of the Part B premium.

You will continue to owe this penalty for as long as you remain enrolled in Medicare Part B.

As mentioned above, the 2019 standard premium for Part B is $135.50 per month. If you owe the standard Medicare Part B premium but sign up for Part B a year after you were initially eligible, the late enrollment fee can add another $13.55 per month to your Part B premium.

Part B excess charges

If you receive services or items covered by Medicare Part B from a health care provider who does not accept Medicare assignment (meaning they do not accept Medicare as full payment), they reserve the right to charge you up to 15 percent more than the Medicare-approved amount.

These additional costs are called Medicare Part B excess charges, and they can potentially add up to thousands of dollars.

How much does Medicare Advantage cost per month?

In 2018, the average monthly premium for Medicare Advantage plans was $35.55 per month.1

Depending on your location, $0 premium plans may be available in your area.

Medicare Part C, also known as Medicare Advantage, is sold by private insurance companies. Medicare Advantage offer the same benefits that are covered by Original Medicare, and most Medicare Advantage plans include additional benefits that Original Medicare doesn’t cover.

Because Medicare Advantage plans are sold by private insurance companies, plan costs (such as coinsurance, copayments and deductibles) can vary based on location, carrier, benefits offered and more.

Find out the average cost of Medicare Advantage plans in your state.

Medicare Advantage Special Needs Plans (SNP) may have lower costs

A Medicare Special Needs Plan (SNP) is a type of Medicare Advantage plan that is designed specifically for someone with a particular disease or financial circumstance.

Many Medicare SNPs cover most of the qualified health care costs for beneficiaries. All SNPs must include prescription drug coverage.

Some Medicare SNPs are designed for people who are dual-eligible, meaning they are eligible for both Medicare and Medicaid. These plans are commonly called Dual-Eligible Special Needs Plans (DSNP).

Medicare Advantage Special Needs Plans can also cater more specifically to the needs of people with specific medical conditions, such as: 

  • Dependence issues with alcohol or other substances
  • Autoimmune disorders
  • Cancer
  • Cardiovascular disorders
  • Chronic heart failure
  • Dementia
  • Diabetes mellitus
  • End-stage liver disease
  • End-Stage Renal Disease (ESRD) that requires dialysis
  • Severe hematologic disorders
  • HIV/AIDS
  • Chronic lung disorders
  • Strokes

Some SNPs can also be available to people who live in a long-term care facility such as a nursing home.

Medicare Advantage plans have an out-of-pocket spending max

When you enroll in a Medicare Advantage plan, you can ask about your specific policy’s out-of-pocket spending limit.

Original Medicare does not include an out-of-pocket spending limit. While it’s not common, you could potentially be responsible for thousands of dollars in out-of-pocket costs if you only have Original Medicare coverage and require extensive medical care throughout the year.

What is the average cost of Medicare Part D prescription drug plans?

In 2018, the average monthly premium for a Medicare Part D plan was $52.23 per month.2

Medicare Part D plan provide coverage solely for prescription medications. Part D plan costs may vary based on your plan and your location.

Learn about the average cost of Part D plans in your state.

Depending on your income, you may be required to pay a higher Part D premium. As with Medicare Part B premiums, this adjusted amount is called the IRMAA (Income-related Monthly Adjustment Amount).

If you are required to pay a higher Part D premium, it will be based on your reported income from two years ago (2017).

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

Medicare Part D deductible

Medicare Part D plans cannot have a deductible of more than $415 per year in 2019.

Some Medicare Part D plans have a $0 deductible. In 2019, 29 percent of Part D plans have no deductible.3

Medicare Part D “donut hole” coverage gap costs

Medicare Part D prescription drug plans and some Medicare Advantage plans have what is known as a “donut hole” or “coverage gap,” which is a temporary limit on how much a Prescription Drug Plan will pay for prescription drug costs.

  • Starting in 2019, Medicare prescription drug plan beneficiaries who enter into the coverage gap will pay 25 percent of their brand name prescription drug costs and 37 percent of their generic drug costs until they reach the level of catastrophic coverage.

  • In 2019, once you’ve spent $5,100 on prescription drugs, you enter the catastrophic coverage range. Once you enter catastrophic coverage, you only pay a small coinsurance or copayment for your covered prescription drugs for the rest of the year.

  • Starting in 2020, Part D beneficiaries will pay 25 percent of the cost of brand name and generic drugs during the coverage gap until reaching catastrophic coverage spending limit.

What is the average cost of Medicare Supplement Insurance (Medigap)?

The average premium paid for a Medicare Supplement Insurance (Medigap) plan in 2018 was $125.93 per month.4

It’s important to note that each type of Medigap plan offers a different combination of standardized benefits. Plans with fewer benefits may offer lower premiums.

Other factors such as age, gender, smoking status, health and where you live can also affect Medigap plan rates.

Medicare Supplement Insurance plans help pay for some of the out-of-pocket expenses you’ll face when you use Medicare Part A and Part B benefits.

These costs can include certain Medicare deductibles, coinsurance, copayments and other charges.

There are 10 different Medigap plans available in most states. You can use the chart below to compare the costs that each type of Medigap plan may cover.

Medigap plans and Medicare Advantage plans are not the same thing. You cannot have a Medigap plan and Medicare Advantage plan at the same time.

Medicare Supplement Insurance Plans 2019
Medicare Supplement Benefits A B C D F1 G K2 L3 M N4
Part A co-insurance and hospital costs
Part B co-insurance or co-payment 50% 75%
First 3 pints of blood 50% 75%
Part A hospice care co-insurance or co-payment 50% 75%
Co-insurance for skilled nursing facility     50% 75%
Medicare Part A deductible   50% 75% 50%
Medicare Part B deductible                
Medicare Part B excess charges                
Foreign travel emergency     80% 80% 80% 80%     80% 80%
1. Plan F offers a high-deductible plan. This plan requires you to pay a $2,300 deductible in 2019 before it covers anything.
2. Plan K has an out-of-pocket yearly limit of $5,560 in 2019. After you pay the out-of-pocket yearly limit and yearly Part B deductible, it pays 100% of covered services for the rest of the calendar year.
3. Plan L has an out-of-pocket yearly limit of $2,780 in 2019. After you pay the out-of-pocket yearly limit and yearly Part B deductible, it pays 100% of covered services for the rest of the calendar year.
4. Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don’t result in an inpatient admission.
View an image version of this table.

Compare Medicare Advantage plan costs in your area

A licensed insurance agent can help you compare the Medicare Advantage plans that are available where you live. You can compare benefits, coverage and the costs of each plan and then choose the right fit for your needs.

 

Compare Medicare plan costs 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.

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

3 Kaiser Family Foundation. Medicare Part D: A First Look at Prescription Drug Plans in 2019. (Oct. 16, 2018). Retrieved from www.kff.org/report-section/medicare-part-d-a-first-look-at-prescription-drug-plans-in-2019-tables.

4 TZ Insurance Solutions LLC internal sales data, 2019. This data is based on the Medicare Supplement Insurance policies TZ Insurance Solutions LLC has sold. It is not a comprehensive national average of all available Medicare Supplement Insurance plan premiums.

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.