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Connect NowHealthcare is expensive. Medicare costs go up every year. Rising Medicare premiums are said to be the fastest growing costs in retirement. Hence it calls for careful consideration and planning from a cost perspective.
This article provides a Part-wise summary of out-of-pocket Medicare costs. Remember that these may go up every year.
This article provides a Part-wise summary of out-of-pocket Medicare costs, including premiums, deductibles and copays/coinsurance. Remember that these may go up every year.
PART A (hospital insurance) Costs
Description |
Out-of-pocket Costs for Part A (2023) |
Monthly Premium |
No monthly premium if you paid social security taxes for at least 40 quarters, up to $506 otherwise |
Maximum Out-of-Pocket |
No limit |
Hospital Stay per Benefit Period |
|
|
$1,600 |
|
$0 copay |
|
$400 per day copay |
|
$800 copay for each ‘lifetime reserve’ day |
All 60 ‘lifetime reserve’ days used up |
All costs paid by you |
Click on Medicare – Part A for more information.
Part B (medical insurance) Costs
You have to pay a monthly premium for Part B, often deducted directly from your Social Security benefits.
Part B premium is based on income from 2 years back and filing status. For example, Part B premiums for 2022 will be based on your 2020 income.
Description |
Out-of-pocket Costs for Part B (2023) |
Monthly Premium |
$164.90 Standard Premium Many of those who paid less than Standard last year will continue to pay less Upto $560.50 (depending on income) |
Annual deductible |
$226 |
Doctor and other medical services (including inpatient care) |
Typically 20% of approved amount |
Outpatient hospital care |
Varies. Typically 20% or more of approved amount |
Home health care & Clinical diagnostic lab services |
$0
|
Most other tests and services
|
20% of approved amount
|
Durable Medical Equipment |
20% of approved amount + other costs
|
Annual wellness visit |
$0 |
Click on Medicare – Part B for more information.
Part C (Medicare Advantage) Costs
Part C (Medicare Advantage or MA) monthly premium varies by plan and its ‘metal tier’ and usually ranges from $0 to over $200 (the range may vary based on Carrier and Location). This is also impacted by additional benefits offered by a plan and whether prescription drug coverage is included. Plans which include drug coverage are called MA-PD (Medicare Advantage – Prescription Drug Plan).
Apart from the monthly premium, your out-of-pocket expenses for part C may include deductibles and coinsurance or copays for various services. These costs may go down for you if you have Medicaid or other help for healthcare expenses.
Note that MA Plans usually have a cap on out-of-pocket expenses. Medicare Part A and Part B do not have such caps.
Click on Part C - Medicare Advantage for more information.
Part D (Prescription Drugs) Costs
Like Part C, Part D monthly premium also varies by plan. Your actual prescription drug plan costs will vary depending on various factors such as carrier, the drugs you use, the plan's formulary, and whether you go to a pharmacy that is in your plan's network. These costs may go down if you get 'Extra Help', which is a program to help with prescription drug costs.
Like Part B, monthly premiums for Part D are also impacted by income and filing status. In 2023, high-income earners could pay up to $76.40 per month additional for Part D coverage.
Click on Part D - Prescription Drugs for more information.
Medicare Supplement Costs
Medicare Supplement plans are standardized. Coverage offered does not vary by Carrier, but depends on Plan Type. All plans of a particular type offer the same coverage, though premiums may still vary.
Carriers may charge different premiums for the same Medicare Supplement Plan type and location. Premiums may also get impacted by other factors such as age, health status, whether an enrollee is a smoker or not, and options like high-deductible plans.
Apart from various Plan Types, Medicare Supplement plans are also categorized based on how their premium varies with age.
Note that all types of Medicare Supplement Plans may not be available in a particular area.
Click on Medicare Supplement Plans for more information.
Click here to learn more about Medicare, its various Parts, different enrollment periods and your costs.
We have also created videos to help you better understand various topics related to Medicare. Select and watch a video explaining the topic of your interest in a simple and intuitive manner.
Remember that you cannot choose just any combination of Parts and Plans. Let Lighted Road Insurance guide you step-by-step through the Medicare ecosystem and help you in selecting the right plan(s) for your needs.
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Last Updated: 01-10-2021