Your Guide to 2019 Medicare Costs

The various parts of Medicare can come with plenty of premiums, deductibles and cost-sharing mechanisms for beneficiaries to be aware of, such as coinsurance or copayments.

In this guide, we detail 2019 Medicare costs for each part of Medicare, including the average costs for private Medicare plans such as Medicare Advantage (Part C) and Medicare Supplement Insurance plans (Medigap).

2019 Medicare Part A Costs

Part A Premiums

Most people don't pay a premium for Medicare Part A in 2019.

How much you pay for Part A premiums is determined by the number of years you or your spouse have worked and paid Medicare taxes.

• If you or your spouse paid Medicare taxes for at least 40 quarters (the equivalent of 10 years), you will receive premium-free Part A.

• If you or your spouse paid Medicare taxes for between 30 and 39 quarters, you will pay $240 per month for Part A in 2019.

• If you or your spouse paid Medicare taxes for fewer than 30 quarters (the equivalent of 7.5 years), you will pay $437 per month for Part A.

A late enrollment penalty may apply to anyone who did not sign up for Medicare Part A during their Initial Enrollment Period.

The Part A late enrollment penalty raises the Part A premium by up to 10%, and it remains in place for twice the number of years that you were eligible for Part A but did not sign up.

Part A Deductible

The Medicare Part A deductible is not annual. Rather, your Part A deductible can reset with each “benefit period.”

A benefit period begins when you are admitted to a hospital or skilled nursing facility for inpatient care, and it ends when you have not been an inpatient for 60 consecutive days.

Part A beneficiaries must satisfy a $1,364 deductible for each benefit period in 2019.

Because the benefit period resets after 60 days of not being an inpatient, it's possible to have more than one benefit period within the same calendar year.

Part A Coinsurance

You pay no coinsurance during the first 60 days of an inpatient hospital stay during each benefit period. This means that your hospital costs are covered at 100% (after you meet your Part A deductible).

• From days 61 through 90 of an inpatient stay, there is a $341 per day coinsurance requirement in 2019.

• After day 91, beneficiaries then begin using their “lifetime reserve days,” which carry a coinsurance of $682 per day in 2019.

• Part A beneficiaries are given a total of 60 lifetime reserve days to use over their lifetime. Once you use your lifetime reserve days, they are gone and you cannot get them back.

• Once all 60 lifetime reserve days are exhausted, beneficiaries are responsible for all costs during a benefit period.

For skilled nursing facility costs, your Part A coinsurance is $170.50 per day for days 21-100 of an inpatient stay in 2019. You are responsible for all costs beyond day 100.

2019 Medicare Part B Costs

Part B Premiums

Medicare Part B requires a monthly premium. The standard premium for Part B in 2019 is $135.50 per month, although some people will pay more than that amount and others may pay less.

There are a few reasons why the standard premium does not apply to everyone.  

• Most people who have their Part B premium deducted directly from their Social Security check will pay a few dollars less than the standard Part B premium.

• The hold harmless provision restricts 2019 Part B premium increases to no more than the cost-of-living adjustment (COLA) made to beneficiaries' Social Security checks.

• Those who do not sign up for Medicare Part B when they first become eligible must pay a late enrollment penalty.

  • The Part B late enrollment penalty equates to 10% of the standard Part B premium for each 12-month period in which you were eligible for Part B but did not enroll.

  • The penalty remains in place for as long as you are enrolled in Part B coverage.  

• Higher income earners may pay an additional amount for their Part B premium. This is called IRMAA, or the Income-Related Monthly Adjusted Amount.

The chart below shows what higher income earners will pay for Medicare Part B in 2019.

The income brackets are based on reported income from two years prior, so their 2019 Part B premium is determined by the income they reported in 2017.

Part B Deductible

The annual deductible for Medicare Part B is $185 per year in 2019.

Part B Coinsurance

After you meet the annual Part B deductible in 2019, you typically pay 20% of the Medicare-approved amount for covered services and items for the rest of the year.

Part B Excess Charges

If you visit a health care provider who does not accept Medicare assignment (which means they don't accept Medicare reimbursement as payment in full for their services), the provider reserves the right to charge you up to 15% more than the Medicare-approved amount.

This cost is known as a Medicare Part B “excess charge.”

2019 Medicare Advantage (Part C) Premiums

Medicare Part A and Part B represent the portion of Medicare provided by the federal government, often called Original Medicare.

• Medicare Part C is also commonly known as “Medicare Advantage.” Medicare Advantage plans are required by law to include all the same benefits as Medicare Part A and Part B.

• Many Medicare Advantage plans can also provide coverage for things like prescription drugs and routine dental, vision and hearing care, which are not covered by Part A or Part B.

The average Medicare Advantage plan premium in 2018 was $35.55 per month, although some plans have $0 premiums.¹

2019 Medicare Prescription Drug Plan (Part D) Premiums

Medicare Part D plans provide coverage only for prescription drugs.

The average Medicare Part D plan premium in 2018 was $52.23 per month, with an average deductible of $244.98.¹ Some Part D plans may feature $0 premiums and/or $0 deductibles.

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 Part D also uses an IRMAA tax for higher income earners, similar to Medicare Part B. The 2019 Part D IRMAA is based on reported income from two years prior (2017).

2019 Medicare Supplement Insurance (Medigap) Plan Premiums

Medicare Supplement Insurance (Medigap) can be used in conjunction with Medicare Part A and Part B.

Medigap plans provide coverage for certain out-of-pocket Medicare expenses such as deductibles, coinsurance and copayments. The average Medigap plan premium in 2018 was $125.93 per month.²

You can use the Medicare Supplement Insurance plans comparison chart below to compare the benefits that each type of standardized Medigap plan available in most states will offer in 2019.

Medicare Cost Assistance Programs

Some federal assistance programs are available to beneficiaries who might struggle to pay for some of their Medicare costs.  

Medicare Savings Programs (MSPs) are federally funded programs that can help pay for certain Medicare premiums, deductibles, copayments and coinsurance.

There are four types of Medicare Savings Programs.

• Qualified Beneficiary Medicare (QMB) Program
  This program helps pay for the Medicare Part A and Part B premium as well as deductibles, copayments and coinsurance.

  Individuals with monthly incomes lower than $1,061 in 2019 and married couples with combined incomes of less than $1,430 per month in 2019 may qualify.

• Specified Low Income Medicare Beneficiary (SLMB) Program
  The SLMB program helps pay for the Part B premium and is available to beneficiaries with monthly incomes of less than $1,269 in 2019 for individuals, or $1,711 per month in 2019 for married couples.

• Qualified Individual (QI) Program
  This program provides assistance with paying the Part B premium. The qualifying income limits are $1,426 per month for individuals in 2019 and $1,923 per month for a married couple in 2019.

• Qualifying Disabled and Working Individuals (QDWI)
  The QDWI helps pay for Medicare Part A premiums and is available to working disabled persons under the age of 65.

  To qualify as an individual, you must have a monthly income of no more than $4,249 in 2019 or resources valued at less than $4,000. Married couples may qualify with an income of less than $5,722 per month in 2019 or financial resources of $6,000 or less.  

These amounts may increase in 2020. If your income and resources are slightly higher, you should still apply.

An additional assistance program is Medicare Extra Help, or the Medicare Part D Low-Income Subsidy (LIS).

• This federal program helps pay for Medicare Part D premiums, deductibles and copayments.

• In order to be eligible, you must be an individual with a monthly income of less than $1,581 in 2019 or resources valued at under $14,390.

• Married couples may be eligible for Extra Help with a combined monthly income of under $2,134 in 2019 or with resources valued at no more than $28,720.

Medicare Supplement Plans Can Help Cover Some of Your Medicare Costs

A Medigap plan can help cover some of your Medicare deductibles, copayments or coinsurance.

A licensed insurance agent can help you compare Medigap plans that are available where you live and help you find a plan that fits your coverage and budget needs.

¹ MedicareSupplement.com's internal analysis of CMS Medicare Advantage landscape source files, May 2018. Data retrieved from https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovGenIn.

² TZ Insurance Solutions LLC internal sales data, 2019. This data is based on the Medicare Supplement Insurance policies TZ Insurance Solutions LLC has sold. It is not a comprehensive national average of all available Medicare Supplement Insurance plan premiums.

Christian Worstell is a health care and policy writer for MedicareSupplement.com. He has written hundreds of articles helping people better understand their Medicare coverage options.