Each part of Medicare comes with out-of-pocket costs.
PREMIUMS AND DEDUCTIBLES
Part A Hospital Insurance
This part of Medicare is premium-free for those who have worked and paid taxes for 10 years (40 quarters). Those who have not worked enough quarters can either qualify based on the record of a spouse or pay a premium for the coverage. In 2019, the monthly premium for Part A is $240 for those who have worked between 7.5 and 10 years or $437 for those who have worked fewer than 7.5 years.
Part B Medical Insurance
Every beneficiary must pay the standard Part B premium. In 2019, that amount is $135.50 a month. Higher-income beneficiaries are subject to a monthly adjustment, ranging from $54.10 to $325.00, depending on income. The Part B deductible this year is $185. Higher income beneficiaries will pay more in premiums. This adjustment is known as the Income-related Monthly Adjustment Amount (IRMAA).
Part D Prescription Drug Coverage
The standard Part D premium in 2019 is $33.19 per month. Premiums vary, starting at $12.00 and go up to over $150. The standard deductible is $415 and can range from nothing up to the $415 limit.
OTHER OUT-OF-POCKET COSTS
Medicare has also established standard out-of-pocket costs for Part A and Part B. (See the chart below.) In 2019, the deductible for inpatient hospitalization is $1,364 and the coinsurance for doctors’ visits is 20%. Each drug plan then sets its own out-of-pocket costs. The standard Part D drug plan has four payment stages: deductible, Initial Coverage, Coverage Gap (donut hole), and Catastrophic Coverage. Depending on an person’s drug regimen, it’s possible to pay four different prices for a medication during a calendar year.