What Does Medicare Cost?

Original Medicare consists of Part A Hospital Coverage and Part B Medical Coverage. For most people Part A will be Free. Part B comes with a Base premium of $164.90 but some people will pay more.

Hospital Part A- Most individuals when nearing retirement age have worked more than 10 years, or 40 Quarters in Government Speak. It’s important because any time worked that adds up to less than 40 Quarters will result in a monthly premium and you’ll have to pay for your Part A Hospital coverage. For example in 2023-
-If you worked between 30 to 39 Quarters then your Part A premium will be $278.00 per month.
-If you worked 29 Quarters or less your Part A premium will be $506.00 per month.  

Hospital Part A Costs-Hospital Part A offers coverage for an Inpatient Hospital stay and time spent in a Skilled Nursing Facility following an Inpatient Hospital stay. An Inpatient Hospital stay is broken down into 60 day benefit periods. If you have to return to the Hospital for the same condition within 60 days the cost share will not apply. The costs are as follows: 
Days 1- 60- Individuals will be responsible for a $1600 deductible.
Days 61- 90- $400.00 Coinsurance Per Day
Days 91- 150- $800.00 Coinsurance Per Day (Utilizing the 60 day Lifetime Allowance)
Days 151 and beyond- All Costs
Skilled Nursing Facility-
Following an Inpatient Hospital stay Medicare will cover 20 days. The costs are as follows:
Days 1- 20- $0 Coinsurance per day
Days 21- 100- $200 Coinsurance per day
​Days 101 and beyond- All costs

Medical Part B- Medicare Part B provides coverage outside of an Inpatient Hospital stay including the Emergency Room. Coverages include Primary Care and Specialist visits, testing, blood work, specialty injectable medications, durable medical equipment, diabetic supplies and testing materials. Doctor prescribed Medication is not covered. (Prescription Medications are covered by Medicare Part D at an additional cost.)

Medical Part B Costs-
Part B Monthly Premium- The Base Monthly Premium for 2023 is $164.90 depending upon income. Some will pay a higher amount-
Income Related Monthly Adjustment Amount (IRMAA) - Some individuals will pay a higher monthly premium due to a higher annual income. For 2023 the base annual income for a single filing individual is $97,000 or less and $194,000 for couples filing jointly. Any amounts above will result in a higher monthly premium and an increase in their Part D monthly premium. Social Security looks back 2 years so for some, their income is not being correctly represented resulting in a higher monthly premium based on wrong information. If your income has gone down you are able to get your monthly premium lowered by filing a “Life Changing Event Form." Please see the Income Chart Below. You can also download the adjustment form from our documents library, there is a link below as well.
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Additionally, Medicare Beneficiaries will have cost sharing when using Medicare Part B services. They are as follows:  
Part B Deductible- $226.00. Individuals will be responsible for the first $226.00 of their Medical coverage. This is an annual deductible and only paid once.
Part B Coinsurance- 20%- Once the deductible is satisfied Medicare will pay 80% of all approved amounts and the Medicare Beneficiary will be responsible for 20%.

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