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Part B - Out-of-pocket Costs

Unlike Part A, everyone who enrolls in Part B has to pay a monthly premium, which depends on income. You will need to pay this even if you opt for Medicare Advantage (Part C). Other costs may include deductibles, copays and coinsurance. This articles outlines your out-of-pocket costs for Part B (medical insurance).

Part B - Out-of-pocket Costs

PART B (Medical Insurance) – Out-of-pocket Costs

Every year, the coverage and your costs for Medicare undergo revisions. It is vital to understand these changes as they may have a direct bearing on your health and finances.

For 2019, the standard Part B monthly premium is $135.50. Those with high incomes will pay more, upto $460.50 per month.  Many people will also pay lower than the standard premium, especially those who were paying less earlier and did not receive an offsetting increase in their social security benefits.

You will pay the standard Part B premium of $135.50 or higher if you are not getting social security benefits or not paying Part B premiums through your social security checks or if you have Medicaid and it pays your Part B premiums.

Description

 

Your Costs (during 2019)

 

Monthly Premium

$135.50 a month is the Standard Part B premium

Upto $460.50 per month for high-income earners

Less than Standard premium for those who were paying less earlier and did not get an offsetting increase in social security benefits

Annual Deductible

$185

Doctor services and outpatient therapy

20% coinsurance typically (some preventive services are free). Maybe higher if assignment not accepted

Durable medical equipment (DME)

20% coinsurance typically. Maybe more if assignment not accepted

Clinical laboratory services

$0 if Medicare-approved

Home health services

$0. Does not include DME

 

Part B premium is income-dependent. If your modified adjusted gross income (MAGI) from 2 years ago exceeds certain levels, you may pay an Income Related Monthly Adjustment Amount (IRMAA).

For 2018, your premium, based on income, is calculated as shown below.

Based on 2017 Modified Annual Gross Income (MAGI)

 

Comments

Individuals

Couples

Part B monthly premium during 2019

Upto $85,000

Upto $170,000

$135.50

N/A

$85,001 - $107,000

$170,001 - $214,000

$189.60

N/A

$107,001 - $133,500

$214,001 - $267,000

$270.90

N/A

$133,501 - $160,000

$267,001 - $320,000

$352.20

N/A

$160,001 - $499,999

$320,001 - 749,999

$433.40

N/A

>$500,000

>$750,000 $460.50 N/A

 

Late Enrollment Penalty

Remember to enroll in Part B when you are first eligible or as soon as your equivalent coverage ends. Else you may end up paying a late enrollment penalty which could be quite steep and will apply for the duration of time you have Part B (rest of life for many people). Your monthly premium for Part B may go up by 10 percent for each full 12-month period delay, an easily avoidable penalty.

                                                                                                                                                  

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: 11-17-2019