Medicare Part AMedicare Part A, also called "hospital insurance," covers the care you receive while admitted to the hospital, skilled nursing facility or other inpatient services. Medicare Part A is part of Original Medicare. does not have a premiumA premium is a fee you pay to your insurance company for health plan coverage. This is usually a monthly cost. cost for enrollees who have worked for at least 10 years.
Medicare Part BMedicare Part B is the portion of Medicare that covers your medical expenses. Sometimes called "medical insurance," Part B helps pay for the Medicare-approved services you receive. premiums for 2022 start at $170.10 and increase depending on your income. Not enrolling on time can increase your premium amount.
Medicare Part A and Part B cover most of your healthcareHealthcare is the industry dedicated to maintaining or improving health and well-being. services (hospital and medical). You can add supplemental insurance to help cover the costs of Original Medicare (Parts A and B)Original Medicare is a fee-for-service health insurance program available to Americans aged 65 and older and some individuals with disabilities. Original Medicare is provided by the federal government and is made up of two parts: Part A (hospital insurance) and Part B (medical insurance)..
Medicare has different parts and plans, but the most common is Original Medicare (Parts A and B). Parts A and B are available to all Americans 65 years of age and older and individuals under 65 with certain disabilitiesA disability is a restriction or lack of ability (resulting from an impairment) to perform an activity in the manner or within the range considered normal for a human being. The Social Security Administration judges disability — and whether you qualify for financial assistance — based on whether you can work..
Keep in mind, Parts A and B provide different coverage:
Part A Hospital Insurance
- Skilled Nursing stays
- Some Home Health
- And more
Part B Medical Insurance
- Doctors services
- Outpatient therapies
- Durable medical equipment
- And more
You need to know, like coverage, they also are different in cost. If you are new to Medicare, we have answers to help you make the right choice for your health and budget.
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The cost of Medicare Part A premiums depends on whether you or your spouse paid income taxes, and for how long. Most individuals won’t pay a Part A premium. Here are some essential facts about Part A and what it costs.
Medicare Part A Premiums
Medicare calculates Part A premium costs by how long you or your spouse have paid Medicare taxes.
Here is an explanation of monthly premiums for Plan A in 2022:
If you or your spouse paid Medicare taxes for 10 years or more
If you or your spouse paid Medicare taxes for more than 7.5 years but less than 10
If you paid Medicare taxes for fewer than 7.5 years
Medicare Part A Deductible
Most Part A costs come from the inpatientInpatient refers to medical care that requires admission to the hospital, usually overnight. hospital deductible. Inpatient care provided at a hospital or skilled nursing facilitySkilled nursing facilities provide in-patient extended care with trained medical professionals to recover from injury or illness and activities of daily living. These facilities provide physical and occupational therapists, speech pathologists and medical professionals assist with medications, tube feedings and wound care. Skilled nursing stays are usually covered under Medicare Part A. will require you to pay the annual deductible.
For the year 2022, the Plan A deductible increased from 2022:
- Medicare Part A deductible 2021: $1,484
- Medicare Part A deductible 2022: $1,556
Medicare Part A Co-insurance
Your Part A deductible will cover the first 60 days [i] of inpatient care. You’re responsible for a daily coinsuranceCoinsurance is the percentage of your medical costs that you pay after you meet your deductible. Your insurance company pays the remaining amount. For example: If you have a $1,000 medical bill and your coinsurance is 20%, you'll pay $200. Your insurance company will cover the final $800. amount beyond 60 days. The type of facility and how long you stay affect the daily coinsurance amount.
Part A coinsurance increases when your length of stay in a facility increases:
- 0 to 60 days
- 61 to 90 days
- You have a lifetime limit of reserve days to use if your stay lasts longer than 90 days.
Medicare Part A daily coinsurance rates for 2022:
- Days 0-60: $0
- Days 61-90: $389 per day
- Lifetime Reserve Days: $778 per day
If you need skilled nursing care, your daily coinsurance amount is $194.50 for days 21-100.
Your monthly premiums and annual deductible help make up the cost of Medicare Part B. These payment amounts answer the question, “How much is Medicare Part B?”
Medicare Part B Premiums
Each year, Medicare Part B premiums can go up or down. How does the 2022 Medicare Part B premium stack up? Here’s a breakdown:
- Medicare Part B premium 2019: $135.50
- Medicare Part B premium 2020: $144.60
- Medicare Part B premium 2021: $148.50
- Medicare Part B premium 2022: $170.10
Your income plays a part in your Part B premium. For 2022, individuals making $91,000 per year or less, and couples making $182,000 or less, pay the standard monthly amount of $170.10 each.
If your individual or joint income is above the standard bracket, you may pay an Income-Related Monthly Adjustment (IRMAA). Find your IRMAA rate for 2022 below:
Annual income: Individual (up to $91,000) & Joint (up to $182,000)
- IRMAA: $0
- Part B premium: $170.10
Annual income: Individual ($91,000 to $114,000) & Joint ($182,000 to $228,000)
- IRMAA: $68
- Part B premium: $238.10
Annual income: Individual ($114,000 to $142,000) & Joint ($228,000 to $284,000)
- IRMAA: $170.10
- Part B premium: $340.20
Annual income: Individual ($142,000 to $170,000) & Joint ($284,000 to $340,000)
- IRMAA: $272.20
- Part B premium: $442.30
Annual income: Individual ($170,000 to $500,000) & Joint ($340,000 to $750,000)
- IRMAA: $374.20
- Part B premium: $544.30
Annual income: Individual ($500,000 and above) & Joint ($750,000 and above)
- IRMAA: $408.20
- Part B premium: $578.30
Part B Late Enrollment Penalty
The last factor that determines your Part B premium amount is when you sign up. If you enroll as soon as you’re eligibleSome health plans require you to meet minimum requirements before you can enroll. for Part B, your monthly premium will follow the formulas above.
If you sign up later, you may pay a 10% penalty for each 12-month period you missed. If you enroll at 67 (when eligible at 65), your monthly premium payment will be 20% higher than the table above.
Medicare Part B Deductible
All Medicare enrollees pay the same monthly deductible. Like your premium, the annual deductible adjusts each year. For example:
- Medicare Part B deductible 2021: $203
- Medicare Part B deductible 2022: $233
Medicare Part B Coinsurance
Once you meet your deductible, you’ll pay 20% of all Medicare-approved services you receive. Services can include doctor services, outpatient therapy and durable medical equipment.
For example: If your doctor charges $100 for visits, you’ll pay 20% ($20) after you’ve met your deductible.
Are you eligible for cost-saving Medicare subsidies?
Original Medicare (Parts A and B) is most common and has remained popular over the years. There are, however, other options that you may want to consider. For example:
Medicare Advantage: Also called Medicare Advantage Plan (Part C)Medicare Advantage (Medicare Part C) is health insurance for Americans aged 65 and older that blends Medicare benefits with private health insurance. This typically includes a bundle of Original Medicare (Parts A and B) and Medicare Prescription Drug Plan (Part D)., this is an alternative to Original Medicare that provides additional benefits like dental, vision and prescription drug coverage. These plans are regulated by Medicare but provided through private insurance companies.
Medigap: Medicare Supplement Insurance (Medigap)Medicare Supplement Insurance (Medigap) is designed to provide coverage that Original Medicare (Parts A and B) does not. Medigap policies are purchased in addition to Original Medicare and have their own monthly premiums you'll need to pay. fills the holes in your policy that aren’t covered by Original Medicare. These are purchased in addition to your Medicare coverage and are offered by private insurance companies.
Medicare Part D: Standalone, private prescription drug insurance that works with Original Medicare. With Medicare Prescription Drug Plan (Part D)Medicare Part D is prescription drug coverage for people enrolled in Medicare. Part D is optional and is offered by private insurance companies., you can enroll at the same time as Original Medicare, or during the Medicare Open Enrollment Period each year from October 15 to December 7.
Medicare & Medicaid: MedicaidMedicaid is a state-based health insurance program for individuals that qualify. Unlike Medicare, Medicaid does not have age restrictions for members. is a public health insurance option designed for people with low-income or limited resources. If you qualify for both Medicare and Medicaid, you are considered “dual eligible”Dual eligible individuals qualify for both Medicare and Medicaid. and can receive greater financial assistance.
No. If you’re enrolled in Original Medicare (Parts A and Part B), your health won’t play a role in how much you pay for your Medicare coverage. Part A is determined by how long you paid Medicare taxes. For Part B, all enrollees pay the same deductible while premiums are calculated using income and whether you signed up on time.
If you’re at least 65 and can’t afford your Medicare Part B premium or deductible, there may be help. Medicare Savings ProgramsMedicare Savings Programs help those with low incomes pay premiums and sometimes coinsurance for Medicare expenses. (MSP) are designed for low-income individuals who have trouble affording healthcare. To help you get started, here are the four types of MSPs, and their most-recent eligibility requirements from 2021:
- Qualified Medicare Beneficiary Program (QMB): helps pay premiums, copays, deductibles and coinsurance for Parts A and B.
- Who’s eligible: individuals with income up to $1,094 per month; couples making up to $1,472
- Specified Low Income Medicare Beneficiary Program (SLMB): helps pay Part B premiums
- Who’s eligible: individuals making up to $1,308 per month; couples making up to $1,762
- Qualified Individual Program (QI): helps pay Part B premiums
- Who’s eligible: individuals making up to $1,469 per month; couples making up to $1,980
- Qualified Disabled and Working Individuals Program (QDWI): helps pay Part A premiums for disabled people that have returned to work
- Who’s eligible: individuals making up to $4,379 per month; couples making up to $5,892
If you need help finding an affordable Medicare plan, contact GoHealth. Our licensed insurance agents can help you navigate the different options and see what makes the most sense for you.
Your first chance to sign up for Original Medicare is during your Initial Enrollment Period (IEP)The Initial Enrollment Period (IEP) is the seven-month period around your 65th birthday when most people are eligible for the first time to enroll in Medicare.. To figure out your IEP, follow the seven-month rule; your enrollment window includes the three full calendar months before the month you turn 65. It remains open during your birth month, and the three months after. For example: If your birthday is in June, your seven-month window will open Mar. 1 and close Sept. 30.
3 months before your 65th birthday: May, April, March
Your birth month: June
3 months after you turn 65: July, August, September
If you missed your IEP, there are other enrollment periods available. You may be eligible for a Special Enrollment Period due to a Qualifying Life Event (QLE). There is also a designated time to change your Medicare plan. Learn all about Medicare’s different enrollment periods — and how GoHealth can help you.