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MEDICARE PART A

Part A Premium

Most people don't pay a monthly premium for Part A. If you buy Part A, you'll pay up to $499 each month.

Hospital Inpatient Deductible

You pay:

• $1,556 deductible for each benefit period
• Days 1-60: $0 coinsurance for each benefit period
• Days 61-90: $389 coinsurance per day of each benefit period
• Days 91 and beyond: $778 coinsurance per each “lifetime reserve day” after day 90 for each benefit period (up to 60 days over insured’s lifetime)
• Beyond lifetime reserve days: all costs

Skilled Nursing Facility Coinsurance

• Days 1–20: $0 for each benefit period
• Days 21–100: $194.50 coinsurance per day of each benefit period
• Days 101 and beyond: all costs

MEDICARE PART B

Premium

• $170.10 each month

Deductible

• $233 per year

MEDICARE PART D

Premium

The Part D monthly premium varies by plan (higher-income consumers may pay more)

• $33.37 (national base beneficiary premium)

Deductible

• $480

Drug Costs

• For the amounts between $480 and $4,430, Medicare pays for drug costs;

• Coverage gap: from $4,430, plan enrollee pays 25% for brand-name or generic drugs until true out-of-pocket spending reaches $7,050;

• After plan enrollee reaches $7,050 in true out-of-pocket spending, Medicare pays about 95% of drug costs.

Catastrophic Coverage

• Insured pays the greater of $3.95 for generic drugs and $9.85 for name brand drugs, or 5% of retail cost, whichever is higher

LONG-TERM CARE

State Mandated Benefits

• Benefits paid under a federally qualified plan are not taxable if the amount paid does not exceed the federal per diem amounts ($450)