Certain Parts of Medicare Have A Monthly Cost And Some Individuals Will Pay More Than Others-
The Original Medicare Cost consists of Part A Hospital Coverage and Part B Medical Coverage. For most people, Part A is Free. Part B has a Base premium of $174.70, but some people pay more.
Hospital Part A Monthly Premium–
Most individuals, when nearing retirement age, have worked more than 10 years, or 40 Quarters in Government Speak. It’s important because any time worked that adds up to less than 40 Quarters will result in a monthly premium, and you’ll have to pay for your Part A Hospital coverage. For example, in 2024-
-If you worked between 30 to 39 Quarters, then your Part A premium will be $278.00 per month.
-If you worked 29 Quarters or less, your Part A premium will be $505.00 per month.
Hospital Part A Coverage–
Hospital Part A offers coverage for an Inpatient Hospital stay and time spent in a Skilled Nursing Facility following an Inpatient Hospital stay. An Inpatient Hospital stay is broken down into 60-day benefit periods. If you have to return to the Hospital for the same condition within 60 days, the cost share will not apply. The costs are as follows:
Hospital Part A Cost Sharing-
In 2024 the Cost Share is as follows:
Days 1- 60- Beneficiaries will be responsible for a $1632 deductible.
Days 61- 90- $408.00 Coinsurance Per Day
Days 91- 150- $816.00 Coinsurance Per Day (Utilizing the 60-day Lifetime Allowance)
Days 151 and beyond- All Costs
Skilled Nursing Facility-
Following an Inpatient Hospital stay, Medicare will cover 20 days. The costs are as follows:
Days 1- 20- $0 Coinsurance per day
Days 21- 100- $200 Coinsurance per day
Days 101 and beyond- All costs
Medical Part B Coverage-
Medicare Part B provides coverage outside of an Inpatient Hospital stay, including the Emergency Room. Coverages include Primary Care and Specialist visits, testing, blood work, specialty injectable medications, durable medical equipment, diabetic supplies, and testing materials. The doctor prescribed Medication is not covered. (Prescription Medications are covered by Medicare Part D at an additional cost.)
Medical Part B Monthly Premium–
Part B Monthly Premium- The Base Monthly Premium for 2023 is $164.90, depending upon income. Some will pay a higher amount-
Income-Related Monthly Adjustment Amount (IRMAA) – Some individuals will pay a higher monthly premium due to a higher annual income. For 2023 the base annual income for a single filing individual is $97,000 or less and $194,000 for couples filing jointly. Any amounts above will result in a higher monthly premium and an increase in their Part D monthly premium. Social Security looks back 2 years, so for some, their income is not being correctly represented, resulting in a higher monthly premium based on wrong information. If your income has gone down you are able to get your monthly premium lowered by filing a “Life Changing EventForm.”Please see the Income Chart Below. You can also download the adjustment form from our documents library, there is a link below as well.
Medical Part B Cost Sharing-
Additionally, Medicare Beneficiaries will have cost sharing when using Medicare Part B services. They are as follows:
Part B Deductible– $226.00. Individuals will be responsible for the first $226.00 of their Medical coverage. This is an annual deductible and is only paid once.
Part B Coinsurance- 20%- Once the deductible is satisfied, Medicare will pay 80% of all approved amounts, and the Medicare Beneficiary will be responsible for 20%.
Frequently Asked Questions
Does Medicare cover all of my Health Insurance costs?
No, there are cost shares with Parts A and B.
Are there annual limits to what I can spend with Medicare?
No, unfortunately there is no cost cap with Medicare which is why it is important to have Health Insurance in place.
Does Part A have a monthly premium?
For some individuals, yes. If you’ve worked for more than 10 years(40 quarters) and paid in you will be entitled to Free Medicare Part A.
Mike Miligi- Owner- Michael M Insurance Services
For over 10 years, Mike has been assisting Seniors and other Medicare-eligible individuals in understanding the ins and outs of Medicare and Medicare Health Insurance options, including Medicare Advantage Plans(Part C), Medicare Supplement Plans(Medigap), Prescription Drug Plans(Part D), and Dental and Vision programs.
Mike is Licensed in seven States and Certified with 11 Insurance Carriers. He has helped thousands of individuals decide on the best course of action for their particular Health Insurance needs. Because Mike is an Independent Medicare Health Insurance Broker, he works for the client, not the Insurance Carriers, and is able to provide his clients with accurate and unbiased Health Insurance options.
