A Closer Look at 2024 Medicare Out-Of-Pocket Costs

• by Christian Worstell
• January 12, 2024
• Reviewed by John Krahnert

Nothing in life is completely free, and that’s true for Medicare.

In this guide, we’ll take a detailed look at the out-of-pocket costs for Medicare beneficiaries and show you a few ways you may be able to get coverage for some of these costs.

*All costs listed are for 2024 unless otherwise noted. 

Medicare premiums

Premiums exist for each part of Medicare. Premiums are typically paid monthly, but in some cases, they may be paid quarterly or yearly.

Part A

Most people receive “premium-free Part A” thanks to paying a sufficient amount of Medicare taxes during their working years.

• If you only paid between 30 and 39 quarters worth of Medicare taxes (7.5 to 9.75 years) you will be required to pay a premium of $278 per month.
  
  
• If you paid fewer than 30 quarters worth of Medicare taxes, your monthly Part A premium could be as high as $505.

Part B

The standard Medicare Part B premium is $174.70 per month. However, the Part B premium is based on your reported taxable income from two years prior.

The table below shows what Part B beneficiaries will pay for their premiums in 2024, based off their 2022 reported income.

Part C (Medicare Advantage)

Medicare Advantage plans are sold by private insurance companies, so premium costs can differ according to plan type, provider and location. The average monthly premium for a Medicare Advantage plan in 2024 is $13.24.¹

Part D (prescription drug coverage)

Medicare Part D plans are also sold by private insurance companies, so plan premiums may vary across the board.

Part D premiums also come with an income-based tier system that uses your reported income from two years prior, similar to how Medicare Part B premiums are calculated.

Part D premiums for 2024 will be based on reported taxable income from 2022, and the breakdown is as follows:

You can compare Part D plans available where you live and enroll in a Medicare prescription drug plan online when you visit MyRxPlans.com.

Medicare deductibles

A Medicare deductible is the amount you must pay for health care services (excluding premiums) before your coverage begins to kick in.

Part A

Part A requires beneficiaries to meet a $1,632 deductible for each benefit period before coverage takes effect.

A benefit period begins the day you are admitted to a hospital or other long-term care facility for inpatient care, and it ends 60 days after being discharged from the facility (if you have not been readmitted during that time).

The Part A deductible can reset more than one time during a calendar year if you were to experience multiple inpatient stays.

Part B

Medicare Part B requires an annual deductible of $240.

Medicare Advantage

Deductibles for Medicare Advantage plans will differ by plan. Plans that offer prescription drug coverage may have a separate deductible for drug coverage and another deductible for the plan’s other benefits.

Not all Medicare Advantage plans include a deductible.

Part D

Deductibles vary according to plan. However, Part D deductibles are not allowed to exceed $545 in 2024, and some Part D plans may not have a deductible at all.

Medicare coinsurance and copayments

Once you meet your deductible, you may have to pay coinsurance or copayments when you receive care. A coinsurance is a percentage of the total bill, while a copayment is a flat fee.

Part A

For an extended stay in a hospital or mental health facility, a copayment of $408 per day is required for days 61-90 of your stay, and $816 per “lifetime reserve day” thereafter.

You have 60 lifetime reserve days to use. Once these reserve days are exhausted, you will be responsible for all costs.

At a skilled nursing facility, a copayment of $204 per day is required for days 21-100 of an inpatient stay, and you are responsible for all costs thereafter.

During hospice care, copayments of no more than $5 are required for drugs and other products used for pain relief or symptom control. A 5 percent coinsurance payment is also required for inpatient respite care.

For durable medical equipment used for home health care, a 20 percent coinsurance payment is required.

Part B

After the Part B deductible is met, you will typically be required to pay up to 20 percent of the Medicare-approved amount for covered services or products.

Medicare Advantage

Coinsurance and copayments will vary according to each plan.

Part D

As with Medicare Advantage plans, coinsurance and copayments will vary according to each Part D plan.

Additional out-of-pocket Medicare costs

Medicare beneficiaries aren’t always done paying out-of-pocket costs after premiums, deductibles and coinsurance or copayments are paid.

Some additional out-of-pocket expenses that can be incurred with Medicare include:

• Part B excess charges
  If you receive services or products that are covered under Part B from a provider that does not accept Medicare assignment, you may be charged up to 15 percent more than the Medicare-approved cost for those services.
  
  
• Foreign emergency care
  Medicare does not typically provide coverage for emergency care received outside of the U.S., except for certain limited situations.
  
  
• First three pints of blood
  The first three pints of blood used for a transfusion are not covered by Medicare.
  
  
• Additional services or products
  While Medicare covers a wide range of services and products, it does not cover everything. Beneficiaries can still find themselves paying out of pocket for care that isn’t covered by Medicare.

It’s also worth noting that Original Medicare does not include an annual out-of-pocket spending limit, which means beneficiaries could potentially pay a limitless amount of costs in a year.   

Managing out-of-pocket Medicare costs

Fortunately, there are some ways you may be able to get coverage for some of your out-of-pocket Medicare costs.

• Apply for a Medicare Supplement Insurance plan
  These plans, also known as “Medigap,” provide coverage for some of Medicare’s out-of-pocket costs, such as deductibles, coinsurance and copayments. Some Medigap plans even include annual out-of-pocket spending limits.
  
  
• Sign up for a Medicare Advantage plan
  Some Medicare Advantage plans may offer a number of additional benefits not covered by Original Medicare.
  
  The increased coordination of care and the focus on preventive health offered by many Medicare Advantage plans can also help reduce out-of-pocket spending and keep beneficiaries healthier.
  
  
• Stay in network and see doctors who accept Medicare
  Some Medicare Advantage plans and Medicare Part D Prescription Drug plans may include networks of participating providers, and plan members can save a considerable amount of money simply by staying inside the network for care.
  
  If you are enrolled in Original Medicare, avoiding health care providers who do not accept Medicare assignment can help you save up to 15 percent on excess charges.

Read additional medicare costs guides to learn more about Medicare costs and how they will affect you.

If you have any additional Medicare questions or are interested in a Medicare Advantage plan that could help you save on some Medicare out-of-pocket costs, you can call to speak with a licensed insurance today.

About the author

Christian Worstell is a senior Medicare and health insurance writer with MedicareAdvantage.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.

Christian’s work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.

Christian has written hundreds of articles for MedicareAvantage.com that teach Medicare beneficiaries the best practices for navigating Medicare. His articles are read by thousands of older Americans each month. By better understanding their health care coverage, readers may hopefully learn how to limit their out-of-pocket Medicare spending and access quality medical care.

Christian’s passion for his role stems from his desire to make a difference in the senior community. He strongly believes that the more beneficiaries know about their Medicare coverage, the better their overall health and wellness is as a result.

A current resident of Raleigh, Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism.

If you’re a member of the media looking to connect with Christian, please don’t hesitate to email our public relations team at Mike@tzhealthmedia.com.

 

 

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