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Each part of Medicare includes different costs, such as deductibles, copayments, coinsurance and other costs.
In this guide, we review Medicare costs in 2019, including the average cost of Medicare Advantage (Part C) plans and the average cost of Medicare Supplement Insurance (Medigap) plans.
How much does Medicare Part A cost in 2019?
Medicare Part A is hospital insurance. When you are admitted for inpatient care at a hospital, skilled nursing facility and certain other types of inpatient facilities, Medicare Part A helps cover the costs of your qualified care.
Part A includes several different costs, such premiums, a deductible and coinsurance.
2019 Part A premium
Most people get Medicare Part A without paying a monthly premium.
To qualify for premium-free Part A, you or your spouse must have worked and paid Medicare taxes for the equivalent of 10 years (40 quarters). Those 40 quarters do not have to be consecutive.
If you do have to pay a premium for Part A, your premium could be as high as $437 per month in 2019.If you paid Medicare taxes for only 30-39 quarters, your 2019 Part A premium will be $240 per month. If you paid Medicare taxes for fewer than 30 quarters, your premium will be $437 per month.
2019 Part A deductible
If you receive inpatient treatment at a hospital or other inpatient facility, Medicare Part A helps pay for your hospital costs once you reach your Medicare Part A deductible.
The Part A deductible is $1,364 per benefit period in 2019.
The Medicare Part A deductible is not annual — you could potentially need to meet this deductible more than once in a given year.
Certain Medicare Supplement Insurance plans cover the Part A deductible:
- Plan B (full coverage)
- Plan C (full coverage)
- Plan D (full coverage)
- Plan F (full coverage)
- Plan G (full coverage)
- Plan N (full coverage)
- Plan K (50% coverage)
- Plan M (50% coverage)
- Plan L (75% coverage)
2019 Part A coinsurance
You are required to pay Part A coinsurance for extended hospital stays after you meet your Part A deductible.
For the first 60 days of a hospital stay, you don’t have to pay Part A coinsurance.
Beginning on day 61 of your hospital stay in 2019, you’re required to pay $341 per day through day 90. After your 90th day in the hospital, you must pay $682 per day for up to 60 additional days in 2019.
After those 60 additional days are used up (called “lifetime reserve days”), you are responsible for all hospital costs.
Medicare Part A requires a copayment for prescription drugs used during hospice care. You might also be charged a 5 percent coinsurance for inpatient respite care costs.
Medicare Part A also requires a coinsurance payment of $170.50 per day in 2019 for inpatient skilled nursing facility stays longer than 20 days. After day 101 of an inpatient skilled nursing facility stay, you must pay all costs.
All Medigap plans in 2019 pay Medicare Part A coinsurance and hospital costs.
What does Medicare Part B cost in 2019?
Medicare Part B covers outpatient medical care, such as trips to the doctor’s office for qualified care and certain durable medical equipment (DME).
Part B includes monthly premiums, an annual deductible, coinsurance and other potential costs.
2019 Part B premiums
In 2019, the standard monthly Medicare Part B premium is $135.50 per month.
Some Medicare beneficiaries may pay more or less per month for their Part B coverage. Your Part B premium is based on your reported income from two years ago (2017).
If you had higher income in 2017, you may pay higher Part B premiums. This increased premium is called the IRMAA (Income-related Monthly Adjustment Amount), which is illustrated in the chart below.
|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|
2019 Part B deductible
You must meet your Part B deductible before Part B will cover any of your qualified outpatient care.
The 2019 Part B deductible is $185 per year.
2019 Part B coinsurance or copayment
You typically pay 20 percent of the Medicare-approved amount for approved services after you meet your Part B deductible.
Plan N covers 100% of the Part B coinsurance, except for a copay of up to $20 for certain office visits and up to $50 for emergency room visits that don’t result in inpatient hospital admission.
Part B late enrollment penalty
The Part B late enrollment penalty is as much as 10 percent of the Part B premium for each 12-month period that you were eligible to enroll but did not.
For example, if you waited three years after your Initial Enrollment Period to sign up for Medicare Part B, your late enrollment penalty could be 30 percent of the Part B premium.
You are responsible for paying this penalty for as long as you remain enrolled in Medicare Part B.
Part B excess charges
If you receive services or medical devices from a health care provider who does not accept Medicare assignment (meaning they do not accept Medicare as full payment), the provider could potentially charge you up to 15 percent more than the Medicare-approved amount.
These additional costs are called Medicare Part B excess charges, and they can potentially cost up to thousands of dollars.
What is the average cost of Medicare Advantage?
In 2018, the average monthly premium for Medicare Advantage plans was $35.55 per month.1
Medicare Part C, also known as Medicare Advantage, is sold by private insurance companies. Medicare Advantage offer the same benefits that are covered by Original Medicare, and most Medicare Advantage plans include additional benefits that Original Medicare doesn’t cover.
Because Medicare Advantage plans are sold by private insurance companies, plan costs (such as coinsurance, copayments and deductibles) can vary based on location, carrier, benefits offered and more.
Medicare Supplement Insurance and Medicare Advantage plans are very different. You cannot have both plans at the same time.
What is the average cost of Medicare Supplement Insurance (Medigap)?
The average Medicare Supplement Insurance plan premium in 2018 was $125.93 per month.2
Each type of Medigap plan offers a different combination of standardized benefits. Plans with fewer benefits may offer lower premiums.
Other factors such as age, gender, smoking status, health and where you live can also affect Medigap plan rates.
You can use the chart below to compare the benefits offered by each of the 10 types of standardized Medigap plans available 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.
How much does Medicare Part D prescription drug coverage cost?
Medicare Part D plans provide coverage solely for prescription drugs.
The average premium paid for a Medicare Part D plan in 2018 was $52.23 per month.1
Some Medicare beneficiaries may pay more or less per month for their Part D coverage. Your Part D premium is based on your reported income from two years ago (2017).
If you had higher income in 2017, you may pay higher Part D premiums. This increased premium is called the IRMAA (Income-related Monthly Adjustment Amount), which is illustrated in the chart below.
|2017 Individual tax return||2017 Joint tax return||2017 Married and separate tax return||2019 Part D premium|
|$85,000 or less||$170,000 or less||$85,000 or less||Your plan premium|
|More than $85,000 and up to $107,000||More than $170,000 and up to $214,000||N/A||Your plan premium + $12.40|
|More than $107,000 up to $133,500||More than $214,000 up to $267,000||N/A||Your plan premium + $31.90|
|More than $133,500 up to $160,000||>More than $267,000 up to $320,000||N/A||Your plan premium + $51.40|
|More than $160,000 up to $500,000||More than $320,000 up to $750,000||More than $85,000 up to $415,000||Your plan premium + $70.90|
|More $500,000||More than $750,000||More than $415,000||Your plan premium + $77.40|
What are the average out-of-pocket Medicare costs?
According to the Kaiser Family Foundation, beneficiaries enrolled in Original Medicare (Part A and Part B) spent $5,806 out of pocket for health care expenses in 2016.3
The chart below illustrates the average out-of-pocket amounts for costs such as dental services, premiums and prescription drugs.
|Expense||Average Amount Spent|
|Long-term care facility||$1,014|
|Skilled Nursing Facility care and home health care||$157|
Excluding premiums, the data shows that Medicare beneficiaries spent an average of $3,166 out of pocket on their care.
That number is on par with a study conducted by The Commonwealth Fund, which projected that Medicare beneficiaries spent an average of $3,024 in 2016, excluding premiums.4
Medicare.gov, Medicare’s official website from the Centers for Medicare and Medicaid Studies (CMS), presents its own estimated out-of-pocket costs for people in good health in 2019, which you can see in the chart below.5
|Expense||Average Amount Spent|
Excluding premiums, CMS estimated that beneficiaries’ out-of-pocket Medicare costs in 2019 come to $6,224, or roughly double the averages compiled by the Kaiser Foundation and The Commonwealth Fund. One reason for this disparity is that the CMS estimation includes only members of Medicare Part A and Part B, which do not include prescription drug coverage.
2019 Medigap plans can help cover some of your Medicare costs
A licensed insurance agent can help you compare Medicare Supplement Insurance plans that are available where you live. They can help you find a plan that fits your coverage needs as well as your budget.
Compare Medigap plan costs in your area.
Or call 888-264-0148 to speak with a licensed insurance agent.
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.
3 Kaiser Family Foundation. An Overview of Medicare. (Feb. 13, 2019). Retrieved from www.kff.org/medicare/issue-brief/an-overview-of-medicare.
4 Schoen, Cathy; Davis, Karen; Willink, Amber. Medicare Beneficiaries’ High Out-of-Pocket Costs: Cost Burdens by Income and Health Status. (May 12, 2017). The Comonwealth Fund. Retrieved from www.commonwealthfund.org/publications/issue-briefs/2017/may/medicare-beneficiaries-high-out-pocket-costs-cost-burdens-income#/#methods.
5 Medicare.gov. Estimated Out-of-Pocket Costs (OOPC) for People in Good Health. Retrieved May 3, 2019, from www.medicare.gov/find-a-plan/staticpages/medigap-out-of-pocket-costs.aspx.