Medicare is one of the most important programs available to older Americans, with tens of millions of people getting essential healthcare coverage through the federal government. However, Medicare isn't free, and the costs involved are often surprising to those who aren't familiar with the program.
Medicare participants pay a variety of charges, including co-payments, coinsurance percentages, and monthly premiums. Those costs tend to rise over time, and 2019 is no exception. Below, we'll go through all the different parts of Medicare and what you can expect to pay for them in the coming year.
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What you'll pay for Part A hospital coverage
One of the most important parts of Medicare often comes with no monthly premium for participants. Hospital insurance coverage, also known as Medicare Part A, is free to those who had 40 quarters of qualifying employment for which they paid Medicare payroll taxes during their careers or are married to a spouse who did so. Those who don't qualify have to make premium payments. Those who have 30 to 39 quarters of qualifying work will pay $240 per month, up $8 from last year. If you have less than 30 quarters, then the monthly charge jumps to $437, up $15 from 2018.
If you end up using your Medicare Part A coverage, then you'll also have to pay deductibles and coinsurance payments for various services. You can see all the options in the table below:
|
Medicare Charge |
2019 Cost (Change From 2018) |
|---|---|
|
Hospital deductible |
$1,364 (up $24) |
|
Coinsurance for days 61-90 of hospital stay |
$341 (up $6) |
|
Coinsurance for days 91 and beyond of hospital stay using lifetime reserve days |
$682 (up $12) |
|
Coinsurance for skilled nursing facility stays |
$170.50 (up $3) |
Data source: Medicare.gov.
What you'll pay for Part B medical coverage
In contrast to Part A, everyone pays a monthly premium for medical coverage under Medicare Part B, which covers doctor visits and most outpatient procedures and services. The standard premium is set to rise to $135.50 per month in 2019, up $1.50 per month from 2018. A small number of participants will pay less than this if the increases in their Social Security benefits in recent years have been insufficient to keep up with the rising cost of Medicare premiums. However, Medicare estimates that only about 1 in 30 people on Medicare will pay premiums less than the $135.50 amount.
Higher monthly premiums apply to those who are considered to be high-income individuals. The table below shows you how much extra you'll pay every month, depending on your level of income.
|
Income Level for Individual Taxpayers* |
Income Level for Joint Filers |
Added Monthly Charge for Part B Premium |
|---|---|---|
|
$85,000 to $107,000 |
$170,000 to $214,000 |
$54.10 |
|
$107,000 to $133,500 |
$214,000 to $267,000 |
$135.40 |
|
$133,500 to $160,000 |
$267,000 to $320,000 |
$216.70 |
|
$160,000 to $500,000 |
$320,000 to $750,000 |
$297.90 |
|
More than $500,000 |
More than $750,000 |
$325 |
Source: Medicare.gov. *Excludes married persons filing separately if they lived together at any time during the year.
Those who are married and file separate returns have just two ranges to consider: Those making $85,000 to $415,000 pay the $297.90 surcharge, while those making more than $415,000 pay $325 extra.
Finally, Part B participants have to pay a deductible. Medicare makes you pay the first $185 in medical care charges, up $2 from 2018 levels.
What you'll pay for Medicare Part D prescription drug coverage and Medicare Advantage
Parts A and B constitute traditional Medicare coverage, but there are other options that some participants use. Prescription drug plans are available under Medicare Part D, with a wide variety of policies available. Others use Medicare Advantage as a substitute for traditional Medicare.
Private insurers offer both Medicare Advantage and Part D plans, and so costs can vary greatly depending on the level of coverage and the insurance company. Although costs generally go up over time, you can sometimes find cheaper plan alternatives. However, it's important to look not only at monthly premium costs but also the out-of-pocket expenses you'll pay for the prescription drugs or other medical care that you'll need.
Every little bit can be a challenge
Many Medicare participants are retired and can't afford to pay any more than they have to for their healthcare coverage. Although 2019's increases to Medicare costs are relatively modest, they'll still put some strain on the finances of millions of older Americans in the coming year.
