How Much Does Medicare Cost?

How Much Does Medicare Cost?

The cost of Medicare is different for every individual.  This is because everyone’s needs are different.  Your cost can also change based on your work history. Most people who have worked for at least 30 quarters & paid taxes to the government will start out at the same rate.

What is important to note when trying to figure out your costs is to first understand the structure of Medicare.  It is broken into 4 parts; However Original Medicare only covers Parts A & B listed below.

PART A Covers:

• • • Inpatient care in a hospital
    • Skilled nursing facility care
    • Nursing home care (inpatient care in a skilled nursing facility that’s not custodial or long-term care)
    • Hospice Care
    • Home Health Care

PART B Covers:

• • • Medically necessary services: Services or supplies that are needed to diagnose or treat your medical condition and that meet accepted standards of medical practice.
    • Preventive services: Health care to prevent illness (like the flu) or detect it at an early stage, when treatment is most likely to work best.

PART C Covers:

• • • Part C are private insurance health plans which are broken into 2 categories.
      • Medicare Advantage Plans – These plans take the place of the federal Medicare insurance plan and are managed by private health insurance companies.
      • Supplemental Plans or MediGap Plans – These plans cover the gaps in the Original Medicare plans and are also managed by private health insurance companies.

PART D Covers:

• • • This is your prescription drug plan or PDP plan.  This is the insurance plan you use to help buy all your medicines from the pharmacy.
    • Private Health Insurance companies normally offer this plan as part of their Part C plans above but also sell a separate PDP only plan for those who only need Part D.

Cost Categories:

Now that  you see the various parts associated with Medicare, Most plans will have the following costs:

• • • • Premiums: This is a monthly cost you pay to keep your insurance active.
      • Deductibles: An amount you pay each year for most eligible medical services or medications before your health plan begins to share in the cost of covered services.
      • Co-Pay: A fixed amount you pay for a covered health care service after you’ve paid your deductible.
      • Co-Insurance: The percentage of costs of a covered health care service you pay (20%, for example) after you’ve paid your deductible.

Lastly, many of the private policies have an Out-of-Packet maximum which is the most you would have to pay in a year.  Original Medicare does not have an Out of Pocket Maximum so in case of an accident which incurs large expenses, you would be responsible for a portion of the total cost.

If you have questions, please feel free to call or set up an appointment below. My job is to educate you so that make the best choice to meet your healthcare needs.