Are you thinking of applying for Medicare? Are you curious about what it costs? Ok, you’re definitely in the right place. Medicare’s costs vary from plan to plan. This type of insurance is not a one-size-fits-all kind of health insurance. When someone decides to enroll in Medicare, there is an assortment of factors that will define its costs. For example, Medicare Part A is sometimes referred to as premium-free Part A. This means that most people will not have to pay a premium or monthly payment. But, there’s a catch, and this is how it goes. You won’t have to pay a premium if (1) You’re 65. (2) You currently get retirement benefits from the Social Security Office or the Railroad Retirement Board. (3) You’re entitled to receive Social Security or Railroad Retirement benefits, but you have yet to apply. (4) You or your spouse at some time, were covered by Medicare through government employment. Now, if you’re under 65, this is how you can get Medicare Part A with no monthly premium. (1) You already had Social Security or Railroad Retirement disability for at least 24 months. (2) You have been diagnosed with End-Stage Renal Disease (Chronic Kidney failure) and you need special care and services, such as dialysis or a kidney transplant.
For those of you who are not eligible to receive premium-free Part A, you’re by all means allowed to purchase it, and this is the cost breakdown. Those of you who buy Medicare Part A in 2021 will pay a monthly premium of either $259 or $471. Why the discrepancy? Glad you asked. The difference between these monthly payments is dependent upon the years you or your spouse worked and paid Medicare taxes (automatically withdrawn from your paycheck). More than likely, if you decide to buy Medicare Part A (1) you must have Part B as well.
(2) You will have to pay the monthly premiums for Part A as well as Part B.
If you’re looking to enroll in Medicare in 2021, and you meet the requirements for premium-free Part A, you will still have to pay for Medicare Part B (remember, this is the medical insurance part of the plan). The premium monthly payment for 2021 is now $148.50. This amount has increased almost $4, from its 2020 monthly premium of $144.60. A recent study has determined that in 2020, individuals with a 2018 AGI (adjusted gross income) of more than $87,000, paid approximately $202.40 monthly premium for Medicare Part B, and a married couple, who filed jointly in 2020, and whose 2018 AGI was more than $174,000, had to pay $491.60 in monthly premiums, for Medicare Part B. Let’s move to the present day, where an individual with a 2019 AGI of more than $88,000, will now pay $207.90 per month for Medicare Part B, and a married couple whose 2019 AGI is over $176,000, will now be required to pay $504.90 in monthly premiums for Medicare Part B.
How about we look at enrolling in a Medicare Advantage Plan. Many of the Advantage plans do not charge a monthly fee. However, if you do happen to enroll in an Advantage Plan that does charge a monthly premium, you will be responsible for not only paying this amount but also paying Medicare Part B as well. In some cases, Medicare Part B, or medical insurance, will pay all of your monthly premium costs, and some will pay part of the cost. When you’re enrolled in a Medicare Advantage Plan (this is different than regular Medicare Part A and B), the copay you’re responsible for when you visit your doctor’s office is likely to be different than the original Medicare copay. In other words, if you’re enrolled in an Advantage plan and you see a doctor that is out-of-network, you will have to pay, what is called, out-of-pocket costs. This is because you have seen a doctor that is not within your particular network. If you decide to enroll in Medicare Advantage Plan Part C (this is Medicare that is offered to you through a private company), the contracted company will completely cover the following plans: HMOs, PPO’s, Private Fee-For-Service Plans, Special Needs Plans and Medicare Medical Savings Account Plans.
Now that we’ve discussed the Medicare Advantage Plans as well as Medicare Part C, let’s get back to regular Medicare Parts A and B, for there is still more information about costs to share with you. Before we begin, let’s make sure you’re up to speed on the different terms, because they can be a little confusing at times. A deductible is an amount of money you must pay, out-of-pocket before your insurance begins. For Medicare Part A, it is $1,484 per benefit period. This benefit period starts the day that you are first admitted into a hospital and ends only when you no longer have received in-hospital care for at least 60 days. Now that we know what a deductible is, let’s move to coinsurance. Coinsurance is exactly what it sounds like; a percentage of the costs that Medicare pays for. This percentage is usually a flat fee.
We can’t forget Medicare Part D (prescription drugs). This insurance plan is critical, considering the number of people on Medicare who need medications on a regular basis. It is estimated that this year, Medicare Part D will cost about $30 a month. For you seniors out there, who rely on costly drugs, might get caught in what’s called a coverage gap. This year, the gap starts when the total amount your plan has paid, reaches $4,130 (this is an increase from $4,020 from last year). When you reach this amount, you will be furnished with a 75% discount on brand-name and generic drugs as well. What’s more, the drug manufacturers will even cover 70% of your bill, then insurers will pay 5% and you, the consumer, will pay 25%. Furthermore, once your out-of-pocket cost reaches $6,550, Medicare will pay the majority of your drug costs.
There’s one more factor to discuss, and that is Medigap. What is Medigap, you ask? Well, Medigap is supplemental insurance. Give us a chance to explain. Supplemental Insurance is health insurance that is provided by a private insurance company, to offset any insurance Medicare will not cover. This includes coinsurance, copays, and even deductibles. It will also offer coverage for traveling outside of the U.S., a service original Medicare does not offer.
We, here at Getmymedicareinsured.com, hope we have provided you with enough information about Medicare, to give you the confidence and knowledge to choose a plan of your own. Whether you decide to go with original Medicare Parts A and B, or you’re feeling adventurous, you might want to choose a Medicare Advantage Plan. Either way, we’re very pleased we had the opportunity to present you with an extensive look into the workings of Medicare; we’re convinced you will choose the plan that fits your every need. Good Luck, Medicare expert.