With Medicare Part A and Part B, you will pay premiums, deductibles, coinsurance, and copayments for your healthcare. The 2021 deductibles are $1,484 per benefit period for Part A and a yearly $203 for Part B. Part B premiums start at $148.50 in 2021. You can expect to pay 20% of the Medicare-approved amount for covered services as coinsurance.
Part A premiums
Most people receive Medicare Part A without having to pay premiums. These people include:
- People who or whose spouse worked and paid Medicare payroll taxes for at least 40 calendar quarters
- People who already receive retirement benefits from Social Security or the Railroad Retirement Board at age 65
- People who are eligible for retirement benefits but haven’t claimed them yet
- People who or whose spouse worked in Medicare-covered government employment
- People under 65 who have been receiving Social Security or Railroad Retirement Board disability benefits for 24 months
- People under 65 who have End-Stage Renal Disease and:
- Worked for at least 40 calendar quarters while paying Medicare payroll taxes or were a government employee,
- Are already eligible for benefits from Social Security or the Railroad Retirement Board, or
- Are the spouse or child of someone who meets one of the first two requirements
If you have to pay Part A premiums, you will pay one of two prices. People who or whose spouse worked between 30 and 39 calendar quarters while paying Medicare taxes will owe $259 each month in 2021 for Part A. People who or whose spouse worked fewer than 30 calendar quarters while paying Medicare payroll taxes will owe $471 each month for Part A.
Part A deductible
The Part A deductible applies for each benefit period within a single year. A benefit period begins when you are admitted in a hospital or skilled nursing facility and ends 60 days after you last receive inpatient care. The Part A deductible for 2021 is $1,484 for each benefit period.
Part A coinsurance
For Medicare Part A, you pay daily coinsurance after a certain number of days of each benefit period have passed while you are an inpatient in a hospital, as a mental health inpatient, or in a skilled nursing facility.
As a hospital inpatient, you pay no coinsurance for the first 60 days. Day 61-90, you will owe a daily coinsurance of $371 in 2021. Beyond day 90, you will pay $742 each day for up to 60 lifetime reserve days. After you run out of lifetime reserve days, you will owe all costs remaining for that benefit period.
As a mental health inpatient, the daily coinsurance costs are the same as a hospital inpatient. You will also pay 20% of the Medicare-approved amount for mental health services you get from doctors while you are an inpatient.
As a skilled nursing facility inpatient, you owe nothing for the first 20 days of each benefit period. Days 21-100, you owe a daily coinsurance of $185.50. Beyond day 100, you owe all costs for that benefit period.
Part B premiums
The standard Part B premium in 2021 is $148.50. If you made more than $88,000 as an individual in 2019 or more than $176,000 as a married couple in 2019, you will pay higher premiums thanks to an additional charge called the Income Related Monthly Adjustment Amount (IRMAA).
Part B deductible
Medicare Part B has a yearly deductible of $203 for 2021.
Part B copayments/coinsurance
You will pay a copayment for Part B-covered outpatient hospital services, but this is capped at 20% of the Medicare-approved amount for covered services. You will pay a copayment for each service provided. Some preventive services do not require a copayment.
For partial hospitalization mental health services, you will owe a daily coinsurance. Expect to pay 20% of the Medicare-approved amount for home health services, outpatient therapy, durable medical equipment, and outpatient hospital services.
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