let us help you

Medicare Part A, B and D

Monthly Premiums

Part A Monthly Premium

Most people don’t pay a premium for Part A because they paid Medicare taxes while working. 

As of 2017, you can pay up to $413 each month for Part A if you don’t qualify to get it premium-free. If you pay a late enrollment penalty, this amount is higher.

Note: If you don’t get Social Security, RRB, or Civil Service benefit payments, and choose to sign up for Part B, you will get a bill. If you choose to buy Part A, you will always get a bill for your premium.

How much does Part B cost?

Part B premiums

You pay a premium each month for Part B. Most people will pay the standard premium amount. However, if your modified adjusted gross income as reported on your IRS tax return from 2 years ago is above a certain amount, you may pay an Income Related Monthly Adjustment Amount (IRMAA). IRMAA is an extra charge added to your premium.

The standard Part B premium amount is $134.00 (or higher depending on your income). However, most people who get Social Security benefits will pay less than this amount.  This is because the Part B premium increased more than the cost-of-living increase for 2017 Social Security benefits.  If you pay your Part B premium through your monthly Social Security benefit, you’ll pay less ($109 on average).  Social Security will tell you the exact amount you’ll pay for Part B in 2017.

You’ll pay a different premium amount if:

  • You enroll in Part B for the first time in 2017.
  • You don’t get Social Security benefits.
  • You’re directly billed for your Part B premiums.
  • You have Medicare and Medicaid, and Medicaid pays your premiums. (Your state will pay the standard premium amount of $134.00.)
  • Your modified adjusted gross income as reported on your IRS tax return from 2 years ago is above a certain amount.

If you’re in 1 of these 5 groups, here’s what you’ll pay:

If your yearly income in 2015 (for what you pay in 2017) was You pay (in 2016)
File individual tax return File joint tax return File married & separate tax return
$85,000 or less $170,000 or less $85,000 or less $134.00
above $85,000 up to $107,000 above $170,000 up to $214,000 Not applicable $187.50
above $107,000 up to $160,000 above $214,000 up to $320,000 Not applicable $267.90
above $160,000 up to $214,000 above $320,000 up to $428,000 above $85,000 and up to $129,000 $348.30
above $214,000 above $428,000 above $129,000 $428.60

 

Part A costs for Covered Services and Items

Blood If the hospital has to buy blood for you, you must either pay the hospital costs for the first 3 pints of blood you get in a calendar year or have the blood donated.  In most cases, the hospital gets blood from blood bank at no charge, and you won’t have to pay for it or replace it.
Home Health care You pay:

  • $0 for home health care services
  • 20% of the Medicare-approved amount for durable medical equipment
Hospice Care You pay:

  • $0 for hospice care
  • A co-payment of up to $5.00 per prescription for outpatient prescription drugs for pain and symptom management
  • 5% of the Medicare-approved amount for inpatient respite care (short-term care given by another caregiver, so the usual caregiver can rest)
  • Medicare doesn’t cover room and board when you get hospice care in your home or another facility where you live (like a nursing home).
Hospital Inpatient Stay You pay:

  • $1,316.00 deductible and no coinsurance for days 1-60 each benefit period
  • $329.00 per day for days 61-90 each benefit period
  • $658.00 per “lifetime reserve day” after day 90 each benefit period (up to 60 days over your lifetime)
  • All costs for each day after the lifetime reserve days
  • Inpatient mental health care in a psychiatric hospital limited to 190 days in a lifetime.
Skilled Nursing Facility Stay You pay:

  • $0 for the first 20 days each benefit period
  • $164.50 per day for days 21-100 each benefit period
  • All costs for each day after day 100 in a benefit period

Part B Costs for Covered Services and Items

Part B Deductible You pay the first $183.00 yearly for Part B-covered service items.
Blood In most cases, the provider gets blood from the blood bank at no charge, and you won’t have to pay for it or replace it.  However, you will pay a co-payment for blood processing and handling service for every unit of blood you get, and the Part B deductible applies.  If the provider has to buy blood for you, you must either pay the provider costs for the first 3 units of blood you get in a calendar year or have the blood donated by you or someone else.
Clinical Laboratory Services You pay $0 for Medicare-approved services
Home Health Services You pay $0 for Medicare-approved services.  You pay 20% of the Medicare-approved amount for durable medical equipment.
Medical and Other Services You pay 20% of the Medicare-approved amount for most doctor services (including most doctor services while you are a hospital inpatient), outpatient therapy*, and durable medical equipment.  Note: In 2017 there may be limits on physical therapy, occupational therapy, and speech language pathology services.  If so, there may be exceptions to these limits.
Mental Health Services You pay 20% of the Medicare-approved amount for most outpatient mental health care.
Other Covered Services You pay co-payment and coinsurance amounts.
Outpatient Hospital Services You pay a coinsurance (for doctor services) or co-payment amount for most outpatient hospital services.  The co-payment for a single service can’t be more than the amount of the inpatient hospital deductible.

WHAT’S NOT COVERED BY PART A AND PART B?

Medicare doesn’t cover everything. If you need certain services that Medicare doesn’t cover, you will have to pay for them yourself unless you have other insurance to take care of the cost. Even if Medicare covers the service or item, you will generally have to pay deductibles, coinsurance, and co-payments on those services. 

Some of the items and services that Medicare doesn’t cover include the following:

  • Long-term care (also called custodial care)
  • Routine dental care or eye care
  • Dentures
  • Cosmetic surgery
  • Acupuncture
  • Hearing aides
  • Exams for fitting hearing aids
  • Routine foot care

Part D Prescription Drug coverage

Medicare Part A and B do not cover prescription drugs. To get prescription drug coverage, you must sign up for Medicare Part D through a private company.

We are not connected with or endorsed by the United States Government or the federal Medicare program