One of the most complex parts about enrolling in Medicare is considerably choosing a plan as well as the expenses that go with it. There are four parts to Medicare in which each have their own premiums, deductibles, copays, and coinsurance. Selecting a Medigap plan may also help with the remaining costs that the plan does not cover. Determining how each plan works in accordance to their coverage is crucial prior to enrolling and allows room to set expectations on what to pay for.
How Much Does Medicare Cost?
Determining Medicare costs is not always easy due to its complexity. It can also be impossible to answer “What is the average monthly Medicare payment?” due to the complexity of the system. Your Medicare premium depends on the benefit options you choose.
Medicare has four parts, but you do not need to enroll in all. You can also select optional Medigap coverage for costs your plan does not cover. Most people receive Medicare Part A free unless they receive benefits early.
Medicare Part A
Part A covers hospital, skilled nursing, and hospice care. For 2021, the deductible you must pay with Medicare Part A is $1,484 for every benefit period. The Medicare program defines a benefit period as beginning on the day you become a hospital inpatient and ending once you have gone 60 days without receiving any hospital care. It is important to note the following:
- You do not have to pay coinsure if you are in the hospital less than 60 days.
- The co-payment is $371 daily per benefit period from the 61st to 90th day and $742 daily for each lifetime reserve day after the 91st day. Each Medicare recipient receives 60 lifetime reserve days.
- You have no co-payment for skilled nursing care the first 20 days once you have paid your deductible.
- The daily cost is $185.50 per benefit period from the 21st to 100th day. You are responsible for all costs after the 101st day.
- Medicare pays for all hospice services.
Medicare Part B
Part B covers everyday health needs such as:
- Doctor appointments
- Preventive care
- Medical equipment
- Urgent care visits
Your premium for 2021 is $148.50 per month if you are unmarried and earn up to $87,000 or married and earn up to $174,000 annually. There are five other income categories for Part B, with the highest being $500,000 if single or $750,000 if married. The maximum Part B cost is $504.90 per month.
Medicare Part C
Part C combines Part A, Part B, and some of Part D into a single coverage plan. You can obtain Medicare Part C through private insurers, but the Medicare program still oversees it. As stated in Key Takeaways, the amount you pay for Part C depends on what the insurance carrier charges and the coverage level you select. Part C also goes by Medicare Advantage, and the Medicare program imposes an out-of-pocket limit. For 2021, the maximum Medicare Advantage cost is $7,550 for in-network services or $11,300 for medical care received outside your primary network.
Medicare Part D
Part D is prescription drug coverage offered by private Medicare-approved insurance companies. Coverage cost varies by state, income, and plan. You must enroll in Part A and Part B, considered the original Medicare, to retain eligibility for Part D. The maximum deductible an insurer can charge in 2021 is $445. Insurers can temporarily reduce coverage once your benefits exceed a certain amount in a specified time period.
Penalty for Late Enrollment
You will pay a 10 to 30% premium difference for Part A, Part B, and Part D if you do not sign up for them when eligible. Each type uses a different set of criteria to determine how long you must pay the extra premium.