Premiums
For Medicare InsuranceMedicare Costs
While Medicare premiums are the same in many states across the US, rates can and do vary in other states, and depending the type of Medicare coverage you have, as well as what health insurance company is approved for your area. Click the menu titles (right) for standard rates which are offered as a guide only. Please call our office to speak with our experienced licensed Medicare agent for accurate rates for your circumstances. We would love to assist you personally.
Disclaimer: The educational information displayed herein regarding Medicare premiums was retrieved from Medicare.gov.
Hospital
Part A
Medical
Part B
Advantage
Part C
Prescription
Part D
Medicare Supplements
Plan Chart
Medicare Part A & B
Part A (Hospital Insurance)
Medicare Premiums Beneficiary Pays for Part A Monthly Premium
Most people do not pay a monthly Part A premium because they or a spouse has 40 or more quarters of Medicare-covered employment.
- $505/month for those with fewer than 30 quarters of Medicare-covered employment
- $278/month for those with 30-39 quarters of Medicare-covered employment
Beneficiary Pays for Skilled Nursing Facility Stay
- $0 for the first 20 days of each benefit period
- $204.00 per day for days 21–100 of each benefit period
- All costs for each day after day 100 of the benefit period
Beneficiary Pays for Hospital Stay
- $1,632 deductible per benefit period
- $0 for the first 60 days of each benefit period
- $408 per day for days 61–90 of each benefit period
- $816 per “lifetime reserve day” after day 90 of each benefit period (up to a maximum of 60 days over your lifetime)
Part B (Medical Insurance)
Medicare Premiums Beneficiary Pays for Part B Monthly Premium
Most people pay the standard Part B premium amount which is $174.70 in 2024
- If your income was more than $91,000 ($182,000 filing joint) you’ll pay $244.60
- If your income was more than $114,000 ($228,000 filing joint) you’ll pay $349.40
- If your income was more than $142,000 ($284,000 filing joint) you’ll pay $454.20
- If your income was more than $170,000 ($340,000 filing joint) you’ll pay $559
- If your income was more than $500,000 ($750,000 filing joint) you’ll pay $594
Beneficiary Pays for Part B Services
- $240.00 deductible per benefit period
- After your deductible is met, you typically pay 20% of the Medicare-approved amount for most doctor services (including most doctor services while you’re a hospital inpatient), outpatient therapy, outpatient mental health services, certain home health services, and durable medical equipment
Medicare Advantage Plans
Part C Plans
Medicare Advantage plans combine Part A and B into one plan and are offered by Medicare-approved health insurance companies as an alternative option to your Original Medicare coverage. Premiums and out-of-pocket costs may vary depending on your plan, however some premiums can be as low as $0, in addition to your monthly Medicare Part B premium (see above). To ensure you find a plan that fits your specific healthcare needs and budget, please contact our licensed Medicare agent for professional assistance.
Prescription Drug Coverage
For 2024 Medicare Part D Costs, most drug plans charge a monthly fee that varies by plan. You pay this in addition to the Part B premium. If you’re in a Medicare Advantage Plan (Part C) or Medicare Cost Plan with drug coverage, the monthly premium may include an amount for drug coverage.
-If your income was more than $91,000 ($182,000 filing joint) you’ll pay $12.90 + your plan premium
-If your income was more than $114,000 ($228,000 filing joint) you’ll pay $33.30 + your plan premium
-If your income was more than $142,000 ($284,000 filing joint) you’ll pay $53.80 + your plan premium
-If your income was more than $170,000 ($340,000 filing joint) you’ll pay $74.20 + your plan premium
-If your income was more than $500,000 ($750,000 filing joint) you’ll pay $81.00 + your plan premium
Deductibles vary between Medicare drug plans. Some Medicare drug plans don’t have a deductible.
-No Medicare drug plan may have a deductible more than $545 in 2024.
Once your deductible is met, you’ll pay a coinsurance (copay) for prescription drugs. Note that the amount of your copay may change during the benefit period, if the drug price fluctuates.
-Initial coverage limit is $5,030(plan pays 75% – you pay 25%)
-Once you and your plan pay this amount, you’ll continue to pay 25% of the cost of your prescriptions drugs until you reach your threshold
-Annual out-of-pocked threshold is $8,000
Once you and your plan have spent $5,030 on covered drugs in 2024, you’re in the coverage gap (a temporary limit on what the plan covers). Even though you’ll only pay 25% for both brand name and generic drugs at this point, almost the full price of the drug (except for what the plan pays) will count as out-of-pocket costs to help you get out of the coverage gap.
-The manufacturer pays 70% of drug costs
-The plan pays 5% of drug costs
-You pay 25% of drug costs
-The plan also pays 75% of a dispensing fee, you pay 25% of the dispensing fee
Once you reach your threshold ($8,000), you are out of the coverage gap (donut hole) and you’ll automatically get catastrophic coverage. This assures you only pay a small coinsurance amount or copayment for covered drugs for the rest of the year.
-You’ll pay 5% or a small copay (whichever is greater) of the cost of your medications for the rest of the year.
-Your plan pays the rest
Beginning Jan. 1, 2023 and beyond, all Medicare Part D and Medicare Advantage plans with prescription coverage will cap the cost of select insulin products at $35.
With this change, you’ll pay no more than $35 for a month’s supply of insulin.
Starting on July 1, people on Original Medicare who use an insulin pump will also pay no more than $35 for a month’s supply of insulin.
Starting in 2023 and beyond, vaccines covered under Medicare Part D will be free.
This means you pay no deductible, coinsurance or copay for vaccines — even the shingles vaccine — covered by Medicare Part D.
Medicare Supplement Plans
Medicare Supplement insurance will lower your medical costs by paying all or a portion of your out-of-pocket costs that your Original Medicare doesn’t cover. Premiums vary depending on the plan you choose, the carrier who offers the plan, the area in which you live and your age. Most often you can see any doctor you wish. Click below to see plans and coverage details. To purchase the right plan for your specific needs and budget, please contact our Licensed Medicare Agent.
Medicare Supplement Plans
Medicare Supplement insurance will lower your medical costs by paying all or a portion of your out-of-pocket costs that your Original Medicare doesn’t cover. Premiums vary depending on the plan you choose, the carrier who offers the plan, the area in which you live and your age. Most often you can see any doctor you wish. Click below to see plans and coverage details. To purchase the right plan for your specific needs and budget, please contact our Licensed Medicare Agent.
Becoming Eligible for Medicare
To sign up for original Medicare Parts A & B, along with Part D, most people will have an Initial Enrollment Period which is a 7 month period around the time they turn age 65. This period begins 3 months before the month you turn 65, includes the month you turn 65, and ends 3 months after the month you turn 65.
Once your Initial Enrollment Period is over, if you wish to change or purchase Advantage or Part D Plans, you must act during the open enrollment period.
NOTICE: Once you are eligible for Medicare, do not wait to enroll in a Medicare Part D Plan or you could end up paying a penalty every month.
SPECIAL ENROLLMENT – OTHER TIMES YOU MAY ENROLL
Once enrolled in Medicare, if you wish to change or purchase Medicare plans you must act during the open enrollment period.
When open enrollment is closed, there are special circumstances in which one may qualify to enroll outside of the enrollment period. Listed below are the qualifying events:
- You are turning 65
- You move to a new area that is not in your current plan’s service area
- Recently moved back to the US
- You lose your current coverage (either Group or Medicaid)
- You now need a SNP (Special Needs Plan) or you no longer need a SNP
Medicare
Open Enrollment
October 15th through December 7th every year.
A Helpful Checklist for New Medicare Recipients
Turning 65? Navigating healthcare through Medicare is not as simple as receiving it through your employer. Here’s a checklist to help make the daunting transition a little easier.
- Review your health insurance needs, taking in consideration medications and regular doctor visits, and any procedures you know you will need.
- See if your current providers accept Medicare.
- Learn the basics of Medicare to find out what Medicare covers. Visit our Medicare Premiums page, or our Medicare & You page to help you get a better understanding of Medicare.
- Talk to a Medicare Professional to help you research the cost of Medicare Advantage, Part D and Medigap Plans in your area and help you decide which is better for your needs.
- Ask your advisor if you qualify for additional benefits or getting help with Medicare costs.
Enrolling in Medicare
You need to enroll in original Medicare (Parts A & B) before you can sign up for a Medicare Advantage or Supplement plan.
To enroll, you will be required to provide proof of your eligibility. Some acceptable documents are birth certificate, proof citizenship if not born in the US, W-2 or tax forms, and or military records.
Follow this link to apply online or call your local Social Security office. Here you can enroll, create your Medicare account, track your Medicare information such as bills, claims, health information and more, as well as print your Medicare card.
Medicare Works For You and Your Health Through the ACA
Reduced prescription drug costs:
In the past when Medicare recipients entered the coverage gap known as the “Donut Hole,” they were responsible for 100% of their prescription costs. The ACA provided discounts and subsidies that reduced those costs by half, and currently, in 2021, the donut hole officially closed for all drugs. In other words, when Medicare recipients enter the coverage gap, they are now responsible for only 25% of the cost of their drugs.
Adds wellness and preventative benefits into Medicare Part B with no additional costs.
Get over a dozen FREE preventative screenings and other wellness benefits that include mammograms, colorectal screenings, heart health, free vaccines and flu shots, addiction programs, mental health services, nutrition assistance and more.
Improves Medicare Advantage
The restructuring of payments to Medicare Advantage, along with bonuses given to plans with higher quality ratings, has forced the plans to be more efficient, which lowers costs for Medicare recipients, while improving quality of care, which probably explains why currently more than a third of Medicare recipients opt for Medicare Advantage vs. original Medicare.