Medicare Premiums

Medicare Parts A & B

While Medicare premiums are the same in many states across the US, rates can and do vary in other states, and depending the type of Medicare coverage you have, as well as what health insurance company is approved for your area. The following standard rates are offered as a guide only. Please call our office to speak with our experienced licensed Medicare agent for accurate rates for your circumstances. We would love to assist you personally.

Part A (Hospital Insurance)

Medicare Premiums Beneficiary Pays for Part A Monthly Premium

 

Most people do not pay a monthly Part A premium because they or a spouse has 40 or more quarters of Medicare-covered employment.

  • $471/month for those with fewer than 30 quarters of Medicare-covered employment
  • $259/month for those with 30-39 quarters of Medicare-covered employment

 

Beneficiary Pays for Skilled Nursing Facility Stay

 

  • $0 for the first 20 days of each benefit period
  • $185.50 per day for days 21–100 of each benefit period
  • All costs for each day after day 100 of the benefit period

Part B (Medical Insurance)

Medicare Premiums Beneficiary Pays for Part B Monthly Premium

 

  • If your income was more than $88,000 ($176,000 filing joint) you’ll pay $207.90
  • If your income was more than $111,000 ($222,000 filing joint) you’ll pay $297.00
  • If your income was more than $138,000 ($276,000 filing joint) you’ll pay $386.10
  • If your income was more than $165,000 ($330,000 filing joint) you’ll pay $475.20
  • If your income was more than $500,000 ($750,000 filing joint) you’ll pay $504.90

 

Beneficiary Pays for Part B Services

 

  • $203.00 deductible per benefit period
  • After your deductible is met, you typically pay 20% of the Medicare-approved amount for most doctor services (including most doctor services while you’re a hospital inpatient), outpatient therapy, outpatient mental health services, certain home health services, and durable medical equipment

Prescription Drug Coverage

Monthly Premium For Medicare Part D

For 2021 Medicare Part D Costs, most drug plans charge a monthly fee that varies by plan. You pay this in addition to the Part B premium. If you’re in a Medicare Advantage Plan (Part C) or Medicare Cost Plan with drug coverage, the monthly premium may include an amount for drug coverage.

 

  • If your income was more than $88,000 ($176,000 filing joint) you’ll pay $12.30 + your plan premium
  • If your income was more than $111,000 ($222,000 filing joint) you’ll pay $31.80 + your plan premium
  • If your income was more than $138,000 ($276,000 filing joint) you’ll pay $12.30 + your plan premium
  • If your income was more than $165,000 ($330,000 filing joint) you’ll pay $12.30 + your plan premium
  • If your income was more than $500,000 ($750,000 filing joint) you’ll pay $12.30 + your plan premium

Yearly Deductible

Deductibles vary between Medicare drug plans. Some Medicare drug plans don’t have a deductible.

 

  • No Medicare drug plan may have a deductible more than $445 in 2021.

Copayments & Out-Of-Pocket Threshold

Once your deductible is met, you’ll pay a coinsurance (copay) for prescription drugs. Note that the amount of your copay may change during the benefit period, if the drug price fluctuates.

 

  • Initial coverage limit is $4,130 (plan pays 75% – you pay 25%)
  • Once you and your plan pay this amount, you’ll continue to pay 25% of the cost of your prescriptions drugs until you reach your threshold
  • Annual out-of-pocked threshold is $6,550

Coverage Gap – Donut Hole

Once you and your plan have spent $4,130 on covered drugs in 2021, you’re in the coverage gap (a temporary limit on what the plan covers). Even though you’ll only pay 25% for both brand name and generic drugs at this point, almost the full price of the drug (except for what the plan pays) will count as out-of-pocket costs to help you get out of the coverage gap.

 

  • The manufacturer pays 70% of drug costs
  • The plan pays 5% of drug costs
  • You pay 25% of drug costs
  • The plan also pays 75% of a dispensing fee, you pay 25% of the dispensing fee

Catastrophic Coverage

Once you reach your threshold ($6,550), you are out of the coverage gap (donut hole) and you’ll automatically get catastrophic coverage. This assures you only pay a small coinsurance amount or copayment for covered drugs for the rest of the year.

 

  • You’ll pay 5% or a small copay (whichever is greater) of the cost of your medications for the rest of the year.
  • Your plan pays the rest

Medicare Advantage Plans
(Medicare Part C)

Medicare Advantage plans combine Part A and B into one plan and are offered by Medicare-approved health insurance companies as an alternative option to your Original Medicare coverage. Premiums and out-of-pocket costs may vary depending on your plan, however some premiums can be as low as $0, in addition to your monthly Medicare Part B premium (see above). To ensure you find a plan that fits your specific healthcare needs and budget, please contact our licensed Medicare agent for professional assistance.  For more information on Medicare Advantage, visit our Medicare Options Compared page.

Medicare Supplement Plans
(Medigap)

Medicare Supplement insurance will lower your medical costs by paying all or a portion of your out-of-pocket costs that your Original Medicare doesn’t cover. Premiums vary depending on the plan you choose, the carrier who offers the plan, the area in which you live and your age. Most often you can see any doctor you wish. Visit our Medicare Supplements Chart page for plans and coverage details. To purchase the right plan for your specific needs and budget, please contact our Licensed Medicare Agent.

Disclaimer:  Miller & Associates Insurance Solutions  is not part of the Federal Government Medicare System. The content in on this page has not been reviewed or approved by Medicare.

 

The educational information displayed herein regarding Medicare premiums was retrieved from Medicare.gov.