How much does Medicare cost?
There are many different parts of Medicare, each with their own costs and coverage levels. We’ve broken them down for you here to help make them easier to understand.
Let’s look at the numbers
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Medicare costs terms explained
If you’re new to Medicare or need a quick refresher, it can be helpful to understand some common terms related to Medicare. Here are some explanations:
Coinsurance: This refers to the percentage of your medical or drug costs that you’re responsible for paying. For example, if your coinsurance is 20%, you would pay 20% of the cost of a prescription drug.
Copayment: This is a fixed dollar amount that you’re responsible for paying for medical services or supplies. For instance, you might be required to pay a $10 copay for a visit to the doctor.
Deductible: This is the amount you have to pay for medical services or prescription drugs in a given year before your plan starts to cover the cost.
Premium: This is the monthly amount you pay to Medicare or your private insurance company for your healthcare coverage.
How much does Original Medicare Part A cost?
What it helps cover:
- Hospital care
- Skilled nursing facility care
- Nursing home care (as long as that isn’t the only care you need)
- Hospice care
- Home healthcare
What it costs:
Most people generally don’t pay a monthly premium for Original Medicare Part A because they paid Medicare taxes while they were working. However, there are costs you may have to cover.
Other Part A costs for 2023:
Most people generally don’t pay a monthly premium for Original Medicare Part A because they paid Medicare taxes while they were working. However, there are costs you may have to cover.
- For in-patient hospital stays, there is an annual deductible of $1,600 in 2023.
- For in-patient hospital stays between days 61 to 90, you’ll be responsible for a daily coinsurance payment of $400 in 2023.
- If you use any lifetime reserve days after day 91, there is a daily coinsurance payment of $800 in 2023 for each day used.
- Once you’ve exhausted the maximum of 60 lifetime reserve days, there will be no further coverage under Part A for in-patient hospital stays.
- For Medicare-approved durable medical equipment (DME), you’ll need to pay a 20% copay.
- If you receive hospice care at home or in a nursing home, you’ll be responsible for paying room and board costs.
- For a skilled nursing facility stay between days 21 to 100, you’ll need to pay a coinsurance payment of $200 in 2023.
- After day 100 of a skilled nursing facility stay, all costs will be your responsibility.
- If you receive mental health services in connection with a hospital stay, you’ll need to pay a 20% copay.
How much does Original Medicare Part B cost?
What it helps cover:
- Medically necessary doctors’ services
- Outpatient care
- Medically necessary chiropractic care
- Home health services
- Durable medical equipment (DME)
- Many preventive services
What it costs:
- Most 2023 Medicare members must pay a monthly premium of $164.90
- If you don’t enroll in Medicare Part B as soon as you are eligible, you could be assessed a late enrollment penalty when you do enroll.
- Your Part B premium could be higher depending on your income.
Other Part B costs for 2023:
- There is a $226 annual deductible for Medicare Part B in 2023. After the deductible, you’ll pay a 20% copay for most doctor services while hospitalized, as well as for DME and outpatient therapy.
- There is a 20% copay of the Medicare-approved amount for doctor visits to diagnose a mental health condition after the deductible.
- There is a 20% copay of the Medicare-approved amount for outpatient services after the deductible.
How much does Medicare Part C (Medicare Advantage) cost?
What it helps cover:
- Medicare Advantage plans are required by law to provide—at minimum—the same coverage, benefits and rights provided by Original Medicare Part A and Part B, with the exception of hospice care.
- Many Medicare Advantage plans also choose to offer prescription drug coverage, as well as coverage for routine dental, vision and hearing benefits.
What it costs:
- Medicare Advantage plans are offered by private insurance companies contracted by the federal government, so they vary in cost, coverage, deductibles and copays.
- Many Medicare Advantage plans offer affordable or $0 premiums plus a variety of coverages and benefits not offered by Original Medicare (Medicare Parts A and B).
How much does Medicare Part D (prescription drug coverage) cost?
What it helps cover:
- Medicare Part D helps cover prescriptions drugs.
- Plan premiums, the drugs that are covered, deductibles, coinsurance and copays will vary by Part D plans, so you should check and compare plans each year based on your needs, the prescription drugs you take, etc.
What it costs:
- Like Medicare Advantage (Part C), prescription drug plans (Part D) are offered by private insurance companies contracted by the federal government.
- There’s a Part D late-enrollment penalty if you don’t enroll in an approved Medicare drug plan (including a Medicare Advantage plan) when you’re first eligible, unless you have other creditable prescriptions drug coverage.
- Your Part D premium could be higher depending on your income.
Our Agents
Our team is made up of compassionate, friendly individuals who understand the unique needs of older adults. We take the time to listen to your concerns and provide personalized solutions that work for you. We provide additional and detailed information on Medicare Health Plans and a no-cost plan comparison to determine if you qualify for additional benefits.
