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2019 Medicare Costs

By December 10, 2018December 22nd, 2022No Comments

In 2019 the Medicare costs are as follows:

Part A: Medicalization.

  • Premium: $437.00 a month.
    • Many people qualify for a premium free benefit of Part A as they have paid taxes for it while working.
  • Deductible: $1,364.
  • This is for each benefit period that occurs.
  • Example – Person A is admitted for a medical procedure as an inpatient, there is a deductible for this occurrence. If Person A is again admitted for a different occurrence, then there will be another deductible that must be paid.
  • Hospital Stays:
  • Days 1-60: $0.00. For each occurrence
  • Days 61-90: $341.00 per day.
  • Days 91 and beyond: $682.00 per day, up to 60 days.
  • Skilled Nursing
  • Days 1 – 20: $0.00.
  • Days 21 – 100: $170.50 per day
  • Days 101 and beyond: All costs

Note: With certain Supplemental Plans (Medigap) the ability to cover all costs of Part A can be achieved as well as extending the number of Hospital Stays to 365 days per year.

Part B: Physician Coverage

  • Premium: $135.50 a month
  • Deductible: $185.00 per year
  • Excess charge: 15%.
    • This charge is for healthcare providers who do not participate in the Medicare program. If they do tend to a Medicare beneficiary, they can charge up to 15 percent of the Medicare cost.

Note: With certain Supplemental Plans (Medigap) the ability to cover the deductible and the excess charge of Part B can be achieved.

Income Related Monthly Adjustment Amount (IRMAA).

IRMAA applies to people with higher incomes who are enrolled in Part B and/or covered under a Medicare Part D Prescription Drug Plan. For those who enter Medicare’s IRMAA there will be a surcharge on top of their monthly Medicare Part B and Part D premiums.

2019 IRMAA Brackets:

2019 IRMAA Brackets

Note: Social Security benefits will automatically pay these IRMAA surcharges. A Medicare beneficiary will receive a bill if they are receiving Social Security.

Part D: Prescription Drug Coverage.

  • Premiums: $46.95 per month.
  • This premium is based on a national average and is combination of plans that also include a deductible.
  • The price of the premiums varies by residency, medications within the plan and by the insurance company that administers the plan.
  • If part of a Medicare Advantage Plan the monthly premium paid for that plan may include the amount for prescription drug coverage.
  • Deductible: $400.25 a year on a national average. Not all plans have a deductible.
  • When enrolling into a Part D plan there is always an option to select a plan that comes with a deductible or not.
  • Within most states, having a Part D plan with a deductible equates in a lower monthly premium.
  • Co-Pays:
  • Set by the insurance company that administers the plan.
  • Co-pays are typically a dollar amount between $1.00 to $50.00 for each prescription filled depending on the type of medication.
  • Co-insurance: 25% to 50%
  • Depending on the medication a plan may charge up to 25% to 50% per prescription.
  • All Co-insurance is set by the insurance company that administers the plan.

Supplemental Coverage (Medigap):

Supplemental Coverage covers the gaps within Medicare Parts A and Part B. Plans can extend coverage as well as cover all deductibles and co-pays that are included in Parts A and B.

  • Private insurers administer the plans and they are regulated by the Centers of Medicare Services (CMS).
  • Plans are broken into different types of plans (A – N) and can have varying types of coverage within the plan.
  • Plan F is considered to be the most robust plan, but a healthcare professional can help determine which plan is best suited.
  • Premium: $208.18 a month on a national average.
    • Premiums vary by residency, age and gender as well as the private insurer who administers the plan.
    • This premium is for Medigap Plan F policy which is blended to include non-tobacco and tobacco users.
    • Premiums may be considerably cheaper depending on age, gender, insurer and residency.

Part C: Medicare Advantage Plans.

Coverage through a private health insurer who, by law, must provide the exact same coverage that Original Medicare (Parts A & B) provides, but still can offer a wide variety of other types of coverage as well.

Due to these plans being able to include specific coverage a national average has not been determined.