Medicare 101

Medicare Out-of-Pocket Costs

Christian Worstell

by Christian Worstell | Published October 08, 2020 | Reviewed by John Krahnert

Original Medicare (Medicare Part A and Part B) covers some hospital and medical costs, but you're responsible for certain out-of-pocket costs, such as deductibles, copayments and coinsurance. 

Medicare Supplement (Medigap) plans can pay for your Medicare out-of-pocket costs.

A couple uses a laptop computer on a table at homeYou can find a Medigap plan online that pays for out-of-pocket Medicare costs.

Medicare Part A out-of-pocket costs

Medicare Part A (hospital insurance) helps cover inpatient hospital stays, skilled nursing facility care, hospice care, and limited home health care services. Let's take a look at some of the costs associated with Medicare Part A below. 

Part A premium

Your monthly premiums are the amounts you pay each month for your Medicare benefits. Most people do not pay a premium for Medicare Part A, as long as they paid sufficient Medicare taxes while working. 

Part A deductible and coinsurance

Your deductible is how much you must pay out of pocket before Medicare will pay its share for covered services. 

In 2019, the Medicare Part A deductible is $1,364 per benefit period. Benefit periods under Part A are based on how long you've been discharged from the hospital, which means you could encounter multiple Part A benefit periods in the same calendar year if you're hospitalized more than once. 

Once your deductible is met, you'll pay a coinsurance for covered inpatient hospital costs. In 2019, the Medicare Part A coinsurance amounts are as follows:

  • First 60 days: No co-insurance

  • Days 61-90: $341 co-insurance per day

  • Days 90+: $682 co-insurance per “lifetime reserve day”

  • Days 90+ if you have no reserve days: Medicare covers nothing

Medicare Part B out-of-pocket costs

Medicare Part B (medical insurance) helps cover outpatient hospital care, doctor’s visits, preventative care, and other medical services. 

Part B premium

The standard Part B premium in 2019 is $135.50 per month. This amount could be higher based on your income. 

Part B deductible and coinsurance

In 2019 the Medicare Part B deductible is $185 per year. Once your Part B deductible is met, you typically pay a 20% coinsurance for covered doctor services, and Medicare pays 80%.

Medigap plans help pay for certain Medicare out-of-pocket costs

Medicare Supplement Insurance (Medigap) plans help pay for certain Medicare out-of-pocket costs, like deductibles, coinsurance and copayments. 

There are 10 standardized Medigap plans available in most states. All 10 Medigap plans provide some level of coverage for:

  • Medicare Part A coinsurance and hospital costs

  • Medicare Part B coinsurance or copayment

  • First three pints of blood

  • Part A hospice care coinsurance or copayment

Speak with a licensed insurance agent today to learn more or to find Medicare Supplement Insurance plans in your area. 

 

Find Medigap plans that cover out-of-pocket costs.

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Resource Center

Compare Medigap Plans 2020

See how the 10 Medigap plans differ. Review our chart for a detailed comparison of Medicare Supplement insurance benefits and compare Medigap options where you live. Read more
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