Medicare Part A and B Cost Basics

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 an illness or injury that limits daily activities. Disability insurance may be part of your health plan, or you may buy it to supplement your health plan. Disability coverage usually pays for some or all of your salary if you can't work..

Keep in mind, Parts A and B provide different coverage:

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.

The cost of Medicare Part A premiums ^[1] 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 2021:

$0/mo.

If you or your spouse paid Medicare taxes for ten years or more

$259/mo.

If you or your spouse paid Medicare taxes for more than 7.5 years but less than 10

$471/mo.

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 2021, the Plan A deductible increased from 2020:

• Medicare Part A deductible 2020: $1,408
• Medicare Part A deductible 2021: $1,484

Medicare Part A Co-insurance

Your Part A deductible will cover the first 60 days ^[2] 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:

• Days 0-60: $0
• Days 61-90: $371 per day
• Lifetime Reserve Days: $742 per day

If you need skilled nursing care, your daily coinsurance amount is $185.50 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 2021 Medicare Part B premium stack up? Here’s a breakdown:

• Medicare Part B premium 2018: $134
• Medicare Part B premium 2019: $135.50
• Medicare Part B premium 2020: $144.60
• Medicare Part B premium 2021: $148.50

Your income plays a part in your Part B premium. For 2021, individuals making $88,000 per year or less, and couples making $176,000 or less, pay the standard monthly amount of $148.50 each.

If your individual or joint income is above the standard bracket, you may pay an Income-Related Monthly Adjustment (IRMAA)Income-Related Monthly Adjustments determine the premium costs for Medicare Part B and Part D based on your income.. Find your IRMAA rate for 2021 below:

Annual income: Individual (up to $88,000) & Joint (up to $176,000)

• IRMAA: $0
• Part B premium: $148.50

Annual income: Individual ($88,000 to $111,000) & Joint ($176,000 to $222,000)

• IRMAA: $59.40
• Part B premium: $207.90

Annual income: Individual ($111,000 to $138,000) & Joint ($222,000 to $276,000)

• IRMAA: $148.50
• Part B premium: $297

Annual income: Individual ($138,000 to $165,000) & Joint ($276,000 to $330,000)

• IRMAA: $237.60
• Part B premium: $386.10

Annual income: Individual ($165,000 to $500,000) & Joint ($330,000 to $750,000)

• IRMAA: $326.70
• Part B premium: $475.20

Annual income: Individual ($500,000 and above) & Joint ($750,000 and above)

• IRMAA: $356.40
• Part B premium: $504.90

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 2020: $198
• Medicare Part B deductible 2021: $203

Medicare Part B Co-insurance

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.

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. It’s also important to know that Medicare Advantage also has its own Annual Enrollment Period (AEP).

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 Prescription Drug Plan (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 fall Enrollment Period.

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.