How Much Does Medicare Cost?

There are four primary monthly costs with Medicare

Medicare Part A

Medicare Part B

Medicare Supplement

Medicare Part D Drug Plan

Medicare Part A

Medicare Part A covers hospital stays, skilled nursing stays, home health and some other minor costs.

For people who are eligible for Medicare due to working at least 40 quarters in their life, or who are eligible due to being the spouse of someone who worked at least 40 quarters, there is no monthly premium for Medicare Part A.

Medicare Part B

Medicare Part B covers pretty much all Medicare-eligible.medical costs that are not covered by Medicare Part A.  These include doctor visits, outpatients services, x-rays, lab work, physical therapy and sophisticated diagnostic testing such as MRIs and CTScans.

Medicare Part B has an annual deductible of $203 in 2021.

For most people the monthly premium for Medicare Part B in 2021 is $148.50.

For Medicare beneficiaries whose Modified Adjusted Gross Income is more than $88,000  (individual) or $176,000 (married filing jointly), they will likely pay  more for Medicare Part B with the amount increasing with their income level.

Medicare Supplements

The monthly premiums for Medicare Supplements vary by state. 

You can get an exact quote for your Medicare Supplement by clicking on the following link

 

Click Here To Request Your Medicare Supplement Quote

Medicare Part D Drug Plans

The monthly premium you will pay for a Medicare Part D drug plan will depend on the specific medications you take.

In most states there are around 25 different Medicare Part D drug plans that very based on the monthly premiums, specific drugs they cover and how much they require the Medicare beneficiary top pay as a co-pay, whether or not there is a deductible and how much the deductible is and to what types of drugs the deductible applies.  The Medicare Part D drug plans will also vary based on which pharmacies are Preferred (lowest cost), Network (higher cost) or Out-of-Network.

Click here to request your Medicare Part D drug plan quote

As with Medicare Part B premiums, Medicare beneficiaries whose Modified Adjusted Gross Income is more than $88,000  (individual) or $176,000 (married filing jointly), they will likely pay  more for Medicare Part D with the amount increasing with their income level.

Finally, a Medicare beneficiary who does not choose a Medicare Part D drug plan when they are first eligible and who does not have alternative creditable coverage may be subject to a Late Enrollment Penalty if they enroll in a Medicare Part D drug plan at a later date.

This Late Enrollment Penalty increases depending on how long the member did not have drug coverage and is a permanent penalty the member will pay the remainder of their life.

You can request a free, no-obligation Medicare Part D drug plan recommendation by clicking on the button below and providing a list of yoru medications.

Click Here To Request Your Medicare Part D Drug Plan Recommendation

Medicare Part D Drug Plan Cost Phases

Medicare Part D drug plans have four phases of costs during which the amount the Medicare beneficiary is required to pay can vary significantly.

The four cost phases for Medicare Part D drug plans are as listed below.  Very importantly, these cost phases and related thresholds are the same for all Medicare Part D drug plans.

Phase 1 - Deductible phase.  During the deductible phase the medicare Part D drug plan member pays the full price of the medication.  In 2021 the standard Medicare Part D deductible is $445.  However, some Medicare Part D drug plans may have a lower deductible and some medications may not be subject to the deductible.Phase 2 - Initial Coverage Phase.  During the initial coverage phase the Medicare Part D drug plan member pays a fixed co-pay for a medication.  The co-pay will vary by medication.Phase 3 - Coverage Gap (Also Called Donut Hole).  Once the Medicare Part D drug plan and the member have together spent a total of $4,020 on covered, the member leaves the Initial Coverage Phase and enters the Coverage Gap.  While in the Coverage Gap the member will pay 25 percent of the cost of a drug.

Phase 4 - Catastrophic Phase - Medicare uses a theoretical calculation called a True .Out-Of-Pocket Cost (TROOP) to determine when a member leaves the Coverage Gap and enters the final phase - Phase 4 Catastrophic Phase.  Luckily for the member, the True Out-Of-Pocket Cost is misnamed and is only a theoretical cost.  The TROOP is the sum of what the member actually has spent on drugs during a calendar year plus the 75 percent the plan payed on the member’s behalf during the Coverage Gap.  Once the member’s TROOP cost reaches $6,350 the member exists the Coverage Gap and enters the Catastrophic Phase during which the member pays 5 percent of the cost of their drug.  In  reality, the member usually will spend around $2,500 in actual expenses before the reach the Catastrophic Phase.

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