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Costs of Original Medicare

Part A:

  • Home Health Care: $0 for home health care services and 20% of the Medicare-approved amount for Durable medical equipment (DME).
  • Hospice Care: $0 for hospice care, no more than a $5 copayment for each prescription drug, 5% of the Medicare-approved amount for inpatient care. Room and board are not covered.
  • Hospital Inpatient Stays: $1,408 deductible for each benefit period, $0 coinsurance for each benefit period for the first 60 days, $352 coinsurance per day of each benefit period up to 90 days, $704 coinsurance per each “lifetime reserve day” after day 90 for each benefit period.
  • Mental Health Inpatient Stays: 20% of the Medicare-approved amount for mental health services you get from doctors and other providers while you’re a hospital inpatient.
  • Skilled Nursing Facility Stay: $0 for each benefit period for the first 20 days, $176 coinsurance per day of each benefit period up to 100 days, all costs beyond 100 days must be paid out-of-pocket.

Part B:

  • Deductible Percentages: After your deductible is met, most pay about 20% of most doctor services, outpatient therapy, and durable medical equipment (DME). You pay $0 for clinical laboratory services.
  • Home Healthcare: $0 for home health care services and 20% of durable medical equipment (DME) costs.
  • Outpatient Mental Healthcare: $0 for depression screenings if accepted, 20% of the Medicare-approved amount for visits to your doctor or other healthcare providers, and additional copayments/coinsurance for outpatient visits.

You will also be required to pay a yearly deductible and monthly premium. The monthly premium you receive is dependent on your income. For Part B, the standard premium is $144.60, and the yearly deductible is $198.

Many people are eligible for premium-free Medicare Part A:

  • You are 65 or older and currently receive Social Security or Railroad Retirement Board (RRB) Benefits.
  • You are 65 or older and eligible for these benefits but have not yet applied.
  • You or your spouse are 65 or older and have/had Medicare-covered by government employment.
  • You are under 65 and received Social Security or RRB disability benefits for at least 24 months.
  • You are under 65 and have End-Stage Renal Disease (ESRD).

If you do not meet these requirements, your Part A premium is based on your income, the average charge being $252 in 2020.

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Costs of Medicare Part C and D

Medicare Advantage, or Medicare Part C, is an alternative coverage option to Original Medicare that provides additional coverage options. Its cost is largely dependent on the provider you choose. The same generally also applies to Part D prescription drug coverage. There are certain factors you can consider to estimate costs:

  • The Plan’s Monthly Premium
  • The Plan’s Yearly Deductible
  • The Plan’s Copayments/Coinsurance
  • The Plan’s Limit on Out-of-Pocket Costs

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