Understanding Medicare Costs - What is Your Responsibility?

Medicare costs at a glance

Listed below are basic costs for people with Medicare. If you want to see and compare costs for specific health care plans, visit Shop and Compare 2020 and 2021 Plans.

For specific cost information (like whether you've met your Deductible, how much you'll pay for an item or service you got, or the status of a Claim), visit MyMedicare.gov.

Find out if Medicare covers a specific test, item or service that's not listed under the detailed Medicare cost information section of this page below.

2020 costs at a glance – 2021 Update Coming – Roughly the same as 2020

Part A premium

Most people don't pay a monthly premium for Part A (sometimes called "premium-free Part A"). If you buy Part A, you'll pay up to $458 each month in 2020. If you paid Medicare taxes for less than 30 quarters, the standard Part A premium is $458. If you paid Medicare taxes for 30-39 quarters, the standard Part A premium is $252.

Part A hospital inpatient deductible and coinsurance

You pay:

  • $1,408 deductible for each benefit period
  • Days 1-60: $0 coinsurance for each benefit period
  • Days 61-90: $352 coinsurance per day of each benefit period
  • Days 91 and beyond: $704 coinsurance per each "lifetime reserve day" after day 90 for each benefit period (up to 60 days over your lifetime)
  • Beyond lifetime reserve days: all costs

Part B premium

The standard Part B premium amount is $144.60 (or higher depending on your income).

Part B deductible and coinsurance

$198. 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, and Durable medical equipment (DME)

Part C premium

The Part C monthly Premium varies by plan. Please visit Shop and Compare 2020 and 2021 Plans.

Part D premium

The Part D monthly Premium varies by plan (higher-income consumers may pay more). Please visit Shop and Compare 2020 and 2021 Plans.

Medicare Supplement Policies – Private Medigap Insurance

Medigap is Medicare Supplement Insurance that helps fill "gaps" in Original Medicare and is sold by private companies. Original Medicare pays for much, but not all, of the cost for covered health care services and supplies. A Medicare Supplement Insurance (Medigap) policy can help pay some of the remaining health care costs, like:

  • Copayments
  • Coinsurance
  • Deductibles

Some Medigap policies also cover services that Original Medicare doesn't cover, like medical care when you travel outside the U.S. If you have Original Medicare and you buy a Medigap policy, here's what happens:

  • Medicare will pay its share of the Medicare-approved amount for covered health care costs.
  • Then, your Medigap policy pays its share.

For plan benefits and cost comparisons, please visit Shop and Compare 2020 and 2021 Plans.

8 things to know about Medigap policies

  1. You must have Medicare Part A and Part B.
  2. A Medigap policy is different from a Medicare Advantage Plan. Those plans are ways to get Medicare benefits, while a Medigap policy only supplements your Original Medicare benefits.
  3. You pay the private insurance company a monthly Premium for your Medigap policy. You pay this monthly premium in addition to the monthly Part B premium that you pay to Medicare.
  4. A Medigap policy only covers one person. If you and your spouse both want Medigap coverage, you'll each have to buy separate policies.
  5. You can buy a Medigap policy from any insurance company that's licensed in your state to sell one.
  6. Any standardized Medigap policy is guaranteed renewable even if you have health problems. This means the insurance company can't cancel your Medigap policy as long as you pay the premium.
  7. Some Medigap policies sold in the past cover prescription drugs. But Medigap policies sold after January 1, 2006 aren't allowed to include prescription drug coverage. If you want prescription drug coverage, you can join a Medicare Prescription Drug Plan (Part D). If you buy Medigap and a Medicare drug plan from the same company, you may need to make 2 separate premium payments. Contact the company to find out how to pay your premiums. For comparison pricing please visit Shop and Compare 2020 and 2021 Plans.
  8. It's illegal for anyone to sell you a Medigap policy if you have a Medicare Advantage Plan, unless you're switching back to Original Medicare.

Medigap policies don't cover everything

Most Medigap policies don't cover Long-term care, vision or dental care, hearing aids, eyeglasses, or private-duty nursing. Some, though do have additional benefits such as

•Over-the-Counter (OTC) items benefit: including up to $100 allowance per quarter at CVS for eligible OTC health and wellness products such as cold and allergy medicines, first-aid supplies, and pain relievers

•Physician consultation benefits: available by phone or video via a computer or mobile application

•Hearing aid benefits: including an annual hearing test and savings on Vista brand mid-level and premium-level hearing aids

•Vision benefits: including coverage for the cost of eye exams, frames, eyeglass, or contact lenses that are not traditionally covered by original Medicare

•SilverSneakers® Fitness Program: includes a fitness benefit at no extra cost

To identify plans with these ancillary benefits, please visit Shop and Compare 2020 and 2021 Plans.

Detailed Medicare cost information for 2020

Medicare Part A (Hospital Insurance) costs

Medicare Part B (Medical Insurance) costs

Medicare Part C (Medicare Advantage)

Medicare Part D (Medicare prescription drug coverage)

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