Medicare Costs Gov’t

Do I qualify for premium-free Part A? 

If you don’t qualify for premium-free Part A: You might be able to buy it. You’ll pay either $278 or $506 each month for Part A, depending on how long you or your spouse worked and paid Medicare taxes.

Remember:

• You also have to sign up for Part B to buy Part A. Learn more about how Medicare works.
• If you don’t buy Part A when you’re first eligible for Medicare (usually when you turn 65), you might pay a penalty. Find out more about how to avoid the Part A penalty.

There’s no limit to the number of benefit periods you can have in a year. This means you may pay the deductible more than once in a year. How do benefit periods work? 

• Days 1-60: $0 after you pay your Part A deductible.
• Days 61-90: $400 copayment each day.
• Days 91-150: $800 copayment each day while using your 60
  lifetime reserve days

  .

• After day 150: You pay all costs.

What’s not covered? 

What will I pay if I get mental health services as an inpatient? 

• Days 1-20: $0 copayment.
• Days 21-100: $200 copayment each day.
• Days 101 and beyond: You pay all costs.

20% of the

for durable medical equipment (like wheelchairs, walkers, hospital beds, and other equipment)

You may also pay:

• A copayment of up to $5 for each prescription drug and other similar products for pain relief and symptom control while you’re at home.
  What if my hospice care doesn’t pay for my drug? 
• 5% of the
  Medicare-approved amount

  for inpatient

  respite care

  .
  What’s not covered? 

Who pays a higher Part B premium because of income? 

You might pay a monthly penalty if you don’t sign up for Part B when you’re first eligible for Medicare (usually when you turn 65). You’ll pay the penalty for as long as you have Part B. The penalty goes up the longer you wait to sign up. Find out how the Part B penalty works and how to avoid it.

as full payment – called “accepting assignment”). Find out how assignment affects what you pay.

• $0 for covered home health care services.
• 20% of the
  Medicare-approved amount

  for durable medical equipment (like wheelchairs, walkers, hospital beds, and other equipment).

for most doctor services while you’re a hospital inpatient.

• $0 for your yearly depression screening.
• 20% of the
  Medicare-approved amount

  for visits to your doctor or other health care provider to diagnose or treat your condition.

• If you get your services in a hospital outpatient clinic or hospital outpatient department, you may have to pay an additional amount to the hospital.

• 20% of the
  Medicare-approved amount

  for each service you get from a doctor or certain other qualified mental health professional

• Coinsurance for each day of partial hospitalization services you get in a hospital outpatient setting or community mental health center

• Usually 20% of the
  Medicare-approved amount

  for doctor and other health care providers’ services.

• You’ll also pay a copayment to the hospital for each service you get in a hospital outpatient setting (except for certain preventive services). In most cases, your copayment won’t be more than the Part A hospital stay deductible amount.
  This additional hospital copayment means you may pay more for an outpatient service you get in a hospital than you’d pay if you got the same service in a doctor’s office.

Compare outpatient procedure costs under Original Medicare.

Compare costs for specific health care plans.

Who pays a higher Part D premium because of income? 

Avoid paying a penalty:

• Join a Medicare drug plan when you first get Medicare Part A and/or Part B, and
• Don’t go 63 days or more without
  creditable drug coverage

  (coverage that’s similar in value to Part D).

Find out more about the Part D penalty.

 policy you buy, where you live, and other factors. The amount can change each year.

• Medigap usually helps pay your portion of the costs (like deductibles and coinsurance) for services that Part A and Part B cover in Original Medicare. The amount you’ll pay for Part A and Part B services if you have a Medigap policy varies depending on the policy you buy.
• Some Medigap policies include extra benefits to lower your costs, like coverage when you travel out of the country.