Medicare Prices in 2020: Original Medicare
Original Medicare (Part A and Part B) services often involve out-of-pocket costs from you, such as a deductible and coinsurance or copayments. Here’s a rundown of some Original Medicare prices:
Medicare prices in 2020: Part A, hospital insurance
- Monthly premium – If you (or your spouse) worked for at least 10 years (40 quarters) while paying Medicare taxes, you generally don’t pay a premium for Part A.
- If you worked 30-39 quarters: $252 per month
- If you worked fewer than 30 quarters: $458 per month
- Deductible – $1,408 in 2020. This is not an annual deductible, but applies to every benefit period. A benefit period starts when you’re admitted as an inpatient, and ends when you haven’t had inpatient care for 60 days in a row.
- Coinsurance – The Medicare prices (in this case, coinsurance) you pay depends on the length of your inpatient hospital stay. The amounts below are per benefit period.
- 0-60 days: $0 coinsurance per day
- 61-90 days: $352 coinsurance per day
- 91 or more days: $704 per day for each lifetime reserve day. These are days when Medicare Part A may cover your care after 90 days in the hospital, and you pay the copayment. You get up to 60 such days in your lifetime.
- After all lifetime reserve days are used up, you’re responsible for all costs.
Please note: The coinsurance amounts listed above generally apply to inpatient hospital costs. Part A costs may be different for skilled nursing facilities and long-term care hospitals.
Medicare prices in 2020: Part B, hospital insurance
- Monthly premium – Medicare prices can vary, but one expense you can typically count on is your Medicare Part B premium (assuming you have Part B). Most people have to pay a monthly premium for Part B, but the amount you pay depends on several things, including your income. The standard Part B premium in 2020 is $144.60.
If your income is higher than a certain amount (based on your tax returns from two years ago), you might have to pay the Part B standard premium and an income adjustment amount on top of that.
- Annual deductible – $198 in 2020
- Coinsurance/copayments – many covered services require a 20% coinsurance. Some services, such as many preventive services, are free.
If you’re worried that your Medicare out-of-pocket costs might get too high for your comfort, you might want to consider a Medicare Supplement plan. Medicare Supplement plans can help pay for your out-of-pocket costs from Medicare Part A and Part B. Learn about Medicare Supplement plans.
Medicare prices in 2020: Part D, prescription drug coverage
- Monthly premium – This can vary among plans. If your income is higher than a certain amount (based on your tax returns from two years ago), you may have to pay a higher amount. The amount that gets added on is called the income-related monthly adjustment amount (Part D IRMAA).
- Annual deductible –This can vary among plans, but no Medicare Prescription Drug Plan is allowed to charge more than in $435 in 2020.
- Coinsurance/copayments – These will vary among plans and medications.
- Coverage gap costs – If you and your Medicare Prescription Drug Plan spend a total of $4,020combined in 2020, you’ll enter the coverage gap. In this spending phase, you’ll pay no more than 25% for brand-name drugs, and no more than 25% for generic drugs, in 2020.
- Catastrophic phase – If you and your Medicare Prescription Drug Plan spend a total of $6,350combined in 2020, you’ll leave the coverage gap and enter the catastrophic phase. For the rest of the year, you’ll typically pay a small coinsurance or copayment for every prescription.
- Late enrollment penalty – When considering Medicare prices, don’t forget the Part D late enrollment penalty. Although Medicare prescription drug coverage (Part D) is optional, there can be a penalty to pay if you don’t sign up for it as soon as you’re eligible. You don’t pay the penalty unless you sign up for a Medicare Prescription Drug Plan later, and you’ve gone more than 63 days in a row after your Medicare Initial Enrollment Period without creditable prescription drug coverage. The penalty may change every year.
To calculate the late enrollment penalty, you take 1% of the national base beneficiary premium ($32.74 in 2020), round it to the nearest $.10, and multiply the result by the number of months that you didn’t have creditable coverage or a Medicare Prescription Drug Plan. You add that figure to the monthly plan premium.
For example, suppose you didn’t sign up for Medicare Part D when you were first eligible for Medicare, and you went 30 months without creditable coverage. Then you decide to enroll in a Medicare prescription drug plan.
- Calculate one percent of the base premium: $ 19 * .01 = $.3274.
- Round it to $.30.
- Multiply $.30 by 30 for the months you went without coverage. $.30 * 30= $9.00.
So, $9 would be the late enrollment penalty added to your monthly Part D premium. This amount could change year by year.
Medicare prices in 2020: Medicare Advantage plans
Medicare prices of Medicare Advantage plans might include monthly premiums, deductibles, coinsurance, and copayments. These costs vary among plans.
When you’re adding up your Medicare prices, remember that if you’re enrolled in a Medicare Advantage plan, you still have to pay your monthly Medicare Part B premium. You also need to pay the Medicare Advantage plan premium – whatever that amount may be. Some plans charge as little as $0 a month.