Sannes Insurance

 Licensed Independent Medicare Insurance Agency

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Out-of-pocket costs for Medicare

What are the out-of-pocket costs for Medicare?

Even though Medicare is taxpayer funded, it is not free. Medicare may cover a significant amount of your medical bills, but it does not cover your costs 100%. It is important to understand that each plan has coinsurance, copayments, and deductibles that you must pay. 

Medicare Part A Out-of-Pocket Costs

Medicare Part A monthly premium:

  • Free if enrolled during initial enrollment period
  • $458 if enrolled after initial enrollment period
  • $252 for those who have paid Medicare taxes for 30 to 39 quarters (or, from 7 years and 6 months, to 9 years and 9 months)

Medicare Part A deductible:

  • $1408 per benefit period (begins on day when you are first admitted into inpatient care; ends after 60 consecutive days of no longer receiving the inpatient care)

Medicare Part A coinsurance per benefit period:

  • $0 for days 1-60
  • $352 for days 61-90
  • $704 for every lifetime reserve day (these are for those who have spent more than 90 days in inpatient care during a benefit period; you are allotted 60 of these in your lifetime)
Medicare Part B Out-of-Pocket Costs

Medicare Part B Monthly Premium:

  • $144.60 (or more if you have a higher level of income)

Medicare Part B deductible:

  • $198

Medicare Part B coinsurance:

  • Once you’ve paid your deductible, you will be paying 20% of the amount approved by Medicare
Medicare Part C and D Out-of-Pocket Costs

These costs are on a case-by-case basis, and depend on the services in your area.

Medicare Part C (also known as Medicare Advantage) could potentially cover Medicare Part B’s premium. This can result in fewer out-of-pocket expenses due to the benefits Medicare Advantage offers.

Medicare Part D will lower the costs for prescription medications, which you will pay at a fraction of the full retail cost. The prescription drug plan you choose may even be covered entirely.

If you have any questions

We are here to assist you with any inquiries you may have regarding Medicare and the various aspects of it. We will help you in any way we can, as we aim to keep your money in your pockets. You did not choose your health problems. However, you can choose how you will get the best treatment at the lowest price. Give us a call today at (509) 993-9887.