There are two parts to Original Medicare — Part A (hospital insurance) and Part B (medical insurance).
While most people receive Part A without a premium, most beneficiaries must pay a premium for Part B. In 2019, the standard Medicare Part B premium is $135.50 per month.
But did you know that your Part B premium could be higher based on your income? Did you also know that you may face other Part B costs, such as a deductible and coinsurance or copays?
Learn more about 2019 Medicare Part B costs and the average premium you might pay, based on your 2017 income.
How Much Does Medicare Part B Cost Monthly in 2019?
The Medicare Part B premium is standardized by the federal government. This means everyone pays the same price, right?
Well, not exactly.
The Income-Related Monthly Adjustment Amount (IRMAA) is an adjusted cost that some beneficiaries must pay for their Part B premium because they have a higher income.
The adjustment amount is based on your reported income from two years prior. This means that if you must pay a Medicare Part B IRMAA in 2019, it is dependent on your reported income from 2017.
The chart below outlines the Part B premium for all income brackets affected by IRMAA.
The CMS estimates that around 5 percent of beneficiaries are affected by IRMAA costs in 2019.1
|2017 Individual tax return||2017 Joint tax return||2017 Married and separate tax return||2019 Part B premium|
|$85,000 or less||$170,000 or less||$85,000 or less||$135.50|
|More than $85,000 and up to $107,000||More than $170,000 and up to $214,000||N/A||$189.60|
|More than $107,000 up to $133,500||More than $214,000 up to $267,000||N/A||$270.90|
|More than $133,500 up to $160,000||More than $267,000 up to $320,000||N/A||$352.20|
|More than $160,000 up to $500,000||More than $320,000 up to $750,000||More than $85,000 up to $415,000||$433.40|
|More $500,000||More than $750,000||More than $415,000||$460.50|
For some beneficiaries, their 2019 average Part B premium may be slightly lower than the standard amount because of three potential factors:
- The hold harmless provision
The Centers for Medicare and Medicaid Services (CMS) reports that around two million people (about 3.5 percent of Medicare beneficiaries) will pay slightly less for their Part B premium in 2019.
This is due to the hold harmless provision, which limits the Part B premium for certain beneficiaries to be no greater than the increase in their Social Security benefits.¹
- Having the Part B premium deducted from a Social Security check
People who have their Part B premium deducted from their monthly Social Security benefits check typically pay a little bit less than people who are billed for their Part B premium each month.
- Medicare Savings Programs
There are three Medicare Savings Programs that help certain qualified Medicare beneficiaries pay their Part B premium.
- Qualified Beneficiary Medicare (QMB) Program
This program helps pay for the Medicare Part A and Part B premium, along with deductibles, copayments and coinsurance.
Individuals can qualify with monthly incomes lower than $1,061 in 2019, and married couples may qualify with combined incomes of less than $1,430 in 2019.
- Specified Low Income Medicare Beneficiary (SLMB) Program
The SLMB program assists with the Part B premium and is available to individuals with monthly incomes less than $1,269 in 2019 or couples with incomes of less than $1,711 per month in 2019.
- Qualified Individual (QI) Program
This program helps pay for the Part B premium. The qualifying income limits in 2019 are $1,426 per month for an individual and $1,923 per month for a married couple.
- Qualified Beneficiary Medicare (QMB) Program
These income limit amounts may increase in 2020. If your income and financial resources are slightly higher than what’s listed above, you should still apply.
What Is the Cost of the Part B Late Enrollment Penalty?
Part B is optional. However, if you do not sign up for Medicare Part B during your Initial Enrollment Period (IEP) and decide you want to enroll in Part B later on, you will be charged a late enrollment penalty for the rest of the time that you have Part B.
The penalty raises your Part B premium by up to 10 percent for each year that you were eligible for Part B but did not sign up. The penalty remains in force for as long as you continue to be enrolled in Part B.
What Are the Other 2019 Medicare Part B Costs?
There are a few other out-of-pocket Part B costs that you may be required to pay in 2019.
- 2019 Part B deductible
The Medicare Part B deductible for 2019 is $185 for the year.
Part B beneficiaries must pay the first $185-worth of Part B covered services out of their own pocket before their Part B coverage kicks in. The deductible resets with each new year.
- 2019 Part B coinsurance or copayment
After you meet your Part B deductible, you are typically required to pay the Part B coinsurance or copayment for additional Part B services you receive in 2019.
Your Part B coinsurance for most services and items is typically 20 percent of the Medicare-approved amount.
- 2019 Part B excess charges
If you visit a provider who does not accept Medicare assignment, that means they still treat Medicare patients but they do not accept Medicare reimbursement as full payment.
These providers are allowed to charge you up to 15 percent more than the Medicare-approved amount for your care. This extra amount is called an “excess charge” and you will be responsible for paying it in full.
Medicare Part B doesn’t include an out-of-pocket spending limit. This means that there is no limit to how much you could potentially pay out-of-pocket for Part B coinsurance costs or Part B excess charges in 2019.
Medicare Supplement Insurance Plans Can Help Cover Some of Your Part B Out-of-Pocket Costs
A Medicare Supplement Insurance (Medigap) plan could help cover certain Part B out-of-pocket costs.
Medicare Supplement Insurance, or Medigap, is a type of private insurance that is used along with Original Medicare (Part A and Part B) to provide coverage for some of Original Medicare’s out-of-pocket costs.
Medicare Supplement Insurance can provide partial or full coverage of your Part B coinsurance or copayments in 2019. Certain Medigap plans can also help cover the Part B deductible and Part B excess charges.
The chart below shows which benefits are covered by the 10 types of standardized Medigap plans that are offered in most states.
|Medicare Supplement Benefits||A||B||C||D||F1||G||K2||L3||M||N4|
|Part A co-insurance and hospital costs||✓||✓||✓||✓||✓||✓||✓||✓||✓||✓|
|Part B co-insurance or co-payment||✓||✓||✓||✓||✓||✓||50%||75%||✓||✓|
|First 3 pints of blood||✓||✓||✓||✓||✓||✓||50%||75%||✓||✓|
|Part A hospice care co-insurance or co-payment||✓||✓||✓||✓||✓||✓||50%||75%||✓||✓|
|Co-insurance for skilled nursing facility||✓||✓||✓||✓||50%||75%||✓||✓|
|Medicare Part A deductible||✓||✓||✓||✓||✓||50%||75%||50%||✓|
|MedicarePart B deductible||✓||✓|
|Medicare Part B excess charges||✓||✓|
|Foreign travel emergency||80%||80%||80%||80%||80%||80%|
|1. Plan F offers a high-deductible plan. This plan requires you to pay a $2,300 deductible in 2019 before it covers anything.
2. Plan K has an out-of-pocket yearly limit of $5,560 in 2019. After you pay the out-of-pocket yearly limit and yearly Part B deductible, it pays 100% of covered services for the rest of the calendar year.
3. Plan L has an out-of-pocket yearly limit of $2,780 in 2019. After you pay the out-of-pocket yearly limit and yearly Part B deductible, it pays 100% of covered services
for the rest of the calendar year.
4. Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don’t result in an inpatient admission.
A licensed insurance agent can help you compare Medicare Supplement Insurance plans in your area. You may be able to find a plan that covers some of your Medicare Part B out-of-pocket costs.
Compare Medigap plan costs in your area.
Or call --ms-tfn-- to speak with a licensed insurance agent.
1 2019 Medicare Parts A & B Premiums and Deductibles. Centers for Medicare & Medicaid Services (Oct. 12, 2018). Retrieved from https://www.cms.gov/newsroom/fact-sheets/2019-medicare-parts-b-premiums-and-deductibles.