Medicare Out-of-Pocket Costs
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.
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.
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Or call 1-800-995-4219 to speak with a licensed insurance agent.