Author: Daniel Petkevich
You might have believed that enrolling in Medicare meant no costs since you've been paying healthcare taxes for years.
Unfortunately, for most Americans, that's a misconception.
Although payroll taxes primarily fund Medicare, beneficiaries may need to pay premiums for certain parts of the program, along with deductibles, copays and coinsurance for most services.
It’s important to understand your potential Medicare costs before enrolling so you can budget for them.
In this article, we'll mostly be exploring your expected Medicare costs if you only have coverage through "Original Medicare" (Parts A & B). Even if you have a Medicare Supplement or Medicare Advantage plan, you still have to pay your Parts A (if any) & B Premiums, but your actual costs for care & deductibles depend on your specific plan. If you choose to get additional coverage for some of the gaps discussed below, one of our agents (1-888-376-2028), or our online tool can explain the various plan options you have along with their costs.
If you or your spouse have worked for more than 10 years (40 quarters) and paid Medicare taxes, then your Medicare Part A premium is zero dollars. However, although you might get Medicare Part A with no premium, you'll still need to pay for the deductibles and coinsurance if you don't have a Medicare Supplement or Advantage Plan.
If you've worked for less than 10 years, Medicare Part A will probably cost you around $499/month. But, if you've worked between 30-39 quarters and paid Medicare taxes, you can get Medicare Part A at a reduced cost of $274/month.
In the case of a hospital stay, you'll have to pay up to $1,556 (your Part A deductible) for each benefit period.
A benefit period begins the day you are admitted to the hospital (or skilled nursing facility) as an inpatient and ends the day you leave the hospital (or after 60 days).
So each time you're admitted to the hospital, you could have to pay $1,556 as your Part A deductible before Medicare starts to pay.
You might also need to pay the Medicare Part A coinsurance for your inpatient stay, which are as follows (for each benefit period):
Days 1-60: $0
Days 61-90: $389 per day
Days 91-150: $778 per day while using your 60 lifetime reserve days.
Beyond lifetime reserve days: All costs
Your Medicare Part B cost can vary depending on your income. Whether you're on Original Medicare, a Medicare Advantage plan, or have a Medicare Supplement, you'll likely have to pay your Part B premium depending on the factors below.
For many people, Medicare Part B typically costs $170.10 per month, but you might be required to pay even more based on your MAGI (modified adjusted gross income).
If your MAGI is above a certain amount (as per your IRS tax return from 2 years ago), you’ll have to pay the standard premium and an income-related monthly adjustment amount (IRMAA).
The table below shows the cost of Medicare Part B, depending on your income.
Medicare Part B IRMAA Chart|Source: Medicare
Again, depending on your plan, you'll likely need to pay the Part B deductible each year before Medicare begins. In 2022, this amounts to $233. If you're only on Original Medicare, you'll also have to pay 20% of the bill for all Medicare-approved medical expenses you incur.
Medicare Part D's cost also depends on your income and your chosen plan.
You can choose from several Medicare Part D plans, some of which cost around $10-$15/month. Each Part D plan has a base premium. You might have to pay a little more if you fall in a higher-income bracket.
The table below will help you determine your Medicare Part D premium based on your income bracket.
Medicare Part D Premium|Source: Medicare
Your Part D deductibles, copays, and coinsurance also depend on the plan you choose.
Medicare Advantage Plans, sometimes called "Part C" or "MA Plans," are offered by private insurance companies approved by Medicare.
Any Medicare Advantage Plan or Part C premium depends on the plan you choose. Some Medicare Advantage plans might have a zero premium, but you still need to pay the Part B premium. Also, the Part C deductibles, copays and coinsurance vary with each plan.
Some plans have an out-of-pocket limit; once you've reached that limit for the year, your plan will cover 100% of your approved healthcare services for the rest of the year.
Medicare Supplement Plan (Medigap) helps cover your Part A and Part B deductibles and copays.
The cost of Medigap depends on the individual plan, where you live, and other factors. However, you still need to pay your Medicare Part B premium. On average, a Medigap could cost you $163/month.
Medicare's initial enrollment period begins 3 months before your 65th birthday and extends until 3 months after your 65th birthday. The late enrollment penalty is a fee you may have to pay if you don't sign up for Medicare Part A and/or Part B when you're first eligible and don't have another form of "creditable" medical coverage.
The late enrollment penalty can increase your Part A and Part B premium by 10%.
You may have to pay this higher monthly premium for Part A for twice the number of years you delayed getting your Part A.
If you delayed your Part B enrollment, you might also have to pay an extra 10% for each year you delayed signing up for Part B. Not to mention, you'll have to pay this high premium for as long as you have Part B.
Your Medicare Part A premium depends on the number of years you were in the workforce, while the cost of Medicare Part B and Part D primarily depends on your income bracket. To accurately evaluate the total cost of Medicare for you, you'll have to look at your income bracket, the number of quarters you've paid Medicare tax, the premium of the plan you choose (if any), and the deductibles and copayments of each plan.
The details of your Medicare cost can seem overwhelming and confusing, but that's what we're here for. Fair Square Medicare helps you understand the gamut of Medicare plans and their costs. Our licensed experts can estimate how much Medicare will cost you so that you can plan ahead. Call us at 1-888-376-2028 for any Medicare-related questions. We're always here to help!
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