It’s no secret that Medicare can save you from a lifetime of medical debt. That’s the reason for its popularity. And for a price, it can be yours to keep. Here, you will see the expected expenses for Medicare.

Medicare’s associated costs are premiums, deductibles, coinsurance, and copayments. These vary based on the Medicare Part(s) you’re enrolled in.

Each cost has its own time at which it must be paid, as well as its role in coverage:

• Premiums: monthly payments; required for keeping your policy
• Deductibles: annual (or per benefit period if Part A); coverage begins after payment
• Coinsurance: when you get treatment; this is what you pay after Medicare pays its share of the costs
• Copayments: also paid upon treatment or service; this is a predetermined cost you pay each time

Medicare Part A Costs

Medicare Part A covers you for inpatient-related care. This is coverage for when you’re admitted in a hospital, skilled nursing facility, hospice, or mental health facility. It pays for the treatments as well as the room you stay in.

Medicare Part A Premiums:

• Its premiums depend on when you sign up and how long you have been paying taxes. You can enroll during the Initial Enrollment Period. This begins three months before the month you turn 65 and lasts until three months after that. 
• If you join when you’re first eligible and you have been working in the U.S. for a minimum of ten years (40 tax quarters), you can get Part A premium-free. If you are not able to get premium-free Part A, you may have to pay a monthly premium of $259 or $471 (as of 2021).
• Joining during the General Enrollment Period (January 1 – March 31) subjects you to paying a late enrollment penalty. The late enrollment penalty tacks on an additional 10% to your premiums, and you will pay this for twice the number of years you waited to join.

Part A Deductible:

• The Part A deductible is based on benefit periods. Benefit periods begin the day you’re admitted as an inpatient and ends once you have gone 60 consecutive days without staying in an inpatient facility.
• The deductible as of 2021 is $1,484 per benefit period.

Part A Coinsurance:

• The coinsurance depends on how long you have been admitted as an inpatient
• You pay nothing in coinsurance for the first 60 days of being in the hospital
• You pay $371 per day if you spend between 61 and 90 days in the hospital
• For days 91-150, you pay $742 per day
• After 150 days, you pay all costs
• For skilled nursing facilities, your coinsurance is $0 for the first 20 days, $185.50 for days 21-100, and every expense afterward

Medicare Part B Costs

Medicare Part B covers outpatient care. This is everything that takes place outside the hospital. X-rays, routine visits, exams, screenings, and durable medical equipment are examples of Part B-covered treatments.

Part B Premiums:

• The monthly Part B premium is $148.50
• If you enroll late, your enrollment penalty accrues an extra 10% per year you wait to join. This penalty is permanent.

Part B Deductible:

• $203 per year (as of 2021)

Part B Coinsurance:

• When you get outpatient treatment with a professional who accepts Medicare assignment, Medicare negotiates a price with that healthcare provider. Medicare then covers 80% of that cost, leaving the remaining 20% up to you.
• Some physicians are non-participating. A non-participating doctor does not have an agreement with Medicare but can make an arrangement. This will still save you money. However, your doctor may charge an additional 15% (this extra percentage is known as excess charges).
• Coinsurance doesn’t apply to opt-out physicians because they charge full price.

Part B Copay:

• Part B copay is the amount you’ll pay each time you go to your doctor’s office. This fee varies between plans. For instance, your copay may be $10 with one plan, but another may offer a $20 copay.

Medicare Part C Costs

Part C, most commonly known as Medicare Advantage, does not have a set cost for its premiums. Costs differ because this is sold through private insurance. 

While not federally regulated, Medicare Advantage has rules of its own. It must offer the same benefits as Parts A and B – and more. For this, you get additional coverage for services such as gym memberships, dental care, eye treatments, and hearing aids.

Medicare Advantage Premiums:

• Differs from plan to plan, but $21 is the average premium in 2021
• You will still need to pay your B premium and your Part A premium if you have one.

Deductibles:

• Many Medicare Advantage policies do not have a deductible. But, because you will need Medicare Parts A and B to enroll, you will be paying those deductibles.

Coinsurance:

• Coinsurance varies, and that’s not just between plans or the companies you purchase the policy from
• This cost is based on your plan’s network
• You will pay less for certain providers even within the same network

Medicare Part D Costs

Medicare Part D covers prescriptions. Like Part C, Part D is sold through private insurance companies. This means there is no standard price, but there are some reliable estimates.

Part D Premiums:

• Average is $33.06

Deductibles:

• No Part D plan deductible may exceed $445

Coinsurance:

• Once you have paid $4,130 on medications plus your deductible, you pay no more than 25% for your prescriptions.
• You will pay 25% up until your out-of-pocket spending reaches $6,550

We’re Here To Help!

At Medicare Peace of Mind, we want you to be aware of all your Medicare options. We provide the solutions and the expertise, in addition to top-notch customer service, to make finding coverage simple for you. Call us today at 970-233-0063.