For educational purposes. and to eliminate erroneous rhetoric.
From Medicare.com
As a Medicare beneficiary, you may need to pay certain out-of-pocket costs, such as premiums, deductibles, copayments and/or coinsurance. These costs are generally standardized for covered services under Original Medicare, Part A and Part B. If you’re enrolled in a Medicare Advantage plan or Medicare Part D Prescription Drug Plan, your out-of-pocket costs may vary by plan.
A premium is the monthly amount you pay for your Medicare coverage or Medicare insurance plan. A deductible is the amount you must pay out-of-pocket each year before your Medicare plan begins sharing costs with you. (Your other out-of-pocket costs may include coinsurance and copayments.)
Premium and deductible amounts may change each year. The Centers for Medicare & Medicaid Services (CMS) usually publishes the Medicare Part A and Medicare Part B rates for the following plan year around the middle of October or November. Medicare-approved private insurance companies publish the new stand-alone Medicare Part D Prescription Drug Plan and Medicare Advantage plan premium and deductible rates for the following year during the fall. If you’re already enrolled in a Medicare Prescription Drug Plan or a Medicare Advantage plan, the plan sends you a document called an Annual Notice of Change.
Medicare Part A premiums
Most beneficiaries over age 65 don’t pay a monthly premium for Medicare Part A coverage if they or their spouse paid Medicare taxes for at least 10 years (or 40 quarters) while working. In fact, according to CMS, most Medicare beneficiaries do not have to pay Medicare premiums on Part A because of their employment Medicare tax history. If you don’t qualify for premium-free Medicare Part A, you may have to pay up to $422 each month.
Medicare Part B premiums
The Medicare Part B premium is set each year by CMS. In 2018, the amount you pay may vary depending on your situation, including when you signed up for Part B.
Here’s how to help determine what you’ll pay for your Part B premium:
- Most Medicare beneficiaries pay less than the standard Part B premium described below. If any of the following situations applies to you, you’ll generally pay the standard amount of $134.00 for your monthly premium:
- You enrolled in Part B for the first time in 2018.
- You aren’t currently receiving retirement benefits from Social Security or the Railroad Retirement Board.
- You’re a dual eligible (have both Medicare and Medicaid), and the Medicaid program pays for the cost of your premiums. If you qualify, your $134 premium is paid by the Medicaid program.
- You’re billed directly for your Part B premium.
Your Part B premium could be higher than $134 if your income is higher than a certain amount (see table below).
2018 Medicare Part B premiums based on income (as reported on your tax return 2 years ago)
Your Annual Income 2018 Premium Amount
Individual Tax Return Joint Tax Return You Pay
$85,000 or less $170,000 or less $134.00
$85,001 up to $107,000 $170,001 up to $214,000 $ 187.50
$107,001 up to $133,500 $214,001 up to $267,000 $ 267.90
Above $133,500 up to $160,000 Above $267,000 up to $320,000 $ 348.30
Over $160,000 Over $320,000 $ 428.60