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WHAT ARE THE COSTS OF ORIGINAL MEDICARE (PARTS A & B)?

Oct 16, 2023 | 3 min read

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KEY TAKEAWAYS

 * How much is Medicare Part A and B? Understanding the costs of Original
   Medicare can help you choose the right coverage options.

 * Most people pay no premiums for Part A. For Medicare Part B in 2024, most
   beneficiaries will pay $174.70 per month.

 * Certain factors may require you to pay more or less than the standard
   Medicare Part B premium in 2024.

   


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What is the total cost of Medicare? Is Medicare going up in 2024? While Medicare
can be a vital part of managing your health care needs, it’s not free—and it
doesn’t cover everything. Understanding your Medicare costs can help you make an
informed decision when choosing a plan.

How much is Medicare Part A and B? Generally, there is no premium for Medicare
Part A if they’ve worked 10 or more years and paid into Social Security. In most
cases, you will pay a monthly premium for Part B. There are other out-of-pocket
costs associated with Medicare Part A and Part B as well.


WHAT ARE THE COSTS FOR MEDICARE PART B?

For Medicare Part B in 2024, most beneficiaries will pay $174.70/month in
premiums. However, there are two scenarios in which you may pay less or more
than this amount:

1. If your Social Security check will not increase enough to cover the
$174.70 premium, you may be subject to the "hold harmless provision." This means
that under federal law:

 * Part B premiums cannot increase in years when there is no Social Security
   cost of living adjustment (COLA), and
 * the net Social Security benefit cannot be lower than the previous year’s
   benefit amount.

In 2023, the Social Security COLA was 8.7%. In 2024, the COLA will be 3.2%. 

2. If you have a higher income, you may pay more for your Part B premiums. The
surcharge is baed on something called an income-related monthly adjustment
amount, or IRMAA. The Social Security Administration (SSA) determines who pays
an IRMAA based on income reported two years prior. In 2024, IRMAA applies to
people whose modified adjusted gross income on their 2022 tax returns was more
than $103,000 per individual or $206,000 for a couple. Medicare beneficiaries
whose income exceeded these amounts will pay a Part B premium ranging from
$244.60 to $594, depending on their exact income.


IS THERE A DEDUCTIBLE FOR MEDICARE PART B?

The deductible refers to the amount you must pay before Medicare begins to pay
its share. Before Medicare starts covering the costs of your care, you will pay
an annual deductible. In 2024, the Part B deductible is $240.

After the deductible has been paid, Medicare pays most (generally 80%) of the
approved cost of care for services under Part B while you pay the remaining cost
(typically 20%) for services such as doctor visits, outpatient therapy, and
durable medical equipment. Medicare has strict rules about what durable medical
equipment, prosthetics, orthotics, and supplies (DMEPOS) are covered.


WHAT ARE THE OUT-OF-POCKET COSTS FOR MEDICARE PART B IN 2024?

Part B Premium  $174.70 monthly for most people Part B Deductible  $240
annually  Part B Coinsurance  20% of service costs, deductible must be paid
first Preventative Benefits There are some services under Part B that Medicare
covers at 100%, such as certain preventive benefits. See Medicare.gov for more
information on these services.


WHAT DOES 'ACCEPTING ASSIGNMENT' MEAN?

Doctors or other providers who accept assignment agree to accept the amount that
Medicare will pay for a visit or service (called the Medicare-approved amount)
as payment in full. This helps to reduce out-of-pocket costs.

Providers who see Medicare beneficiaries but do not accept assignments can
charge up to 15% more than the Medicare-approved amount. Out-of-pocket costs
could be the standard 20% coinsurance—plus up to an extra 15%.







For example, if the Medicare-approved amount for a doctor visit was $100, but a
doctor did not accept the assignment, they could charge up to $115 for the
visit. Out-of-pocket costs could be $35 (20% of the $100 Medicare-approved
amount, plus the extra $15 not covered by Medicare).


WHAT ARE THE COSTS FOR MEDICARE PART A?

Part A is often called hospital insurance because it pays for care while you’re
admitted at the hospital. It also pays some costs outside a hospital, such as
skilled nursing facility stays, home healthcare, and hospice care.

Most Medicare recipients (99%) do not owe a monthly premium for Medicare Part A
because they (or their spouse) paid it while working for a minimum of about 10
years. This is often called “premium-free Part A.” If you or your spouse did not
work for long enough, you can buy Part A (“premium Part A”). If you have premium
Part A in 2024, you’ll owe either the full premium or a prorated amount. 


WHAT WILL I PAY FOR MONTHLY PART A PREMIUMS IN 2024?

Time Worked* Premium Cost For 10 or more years  $0 Between 7.5 and 10 years
 $278 For fewer than 7.5 years  $505

*If you or your spouse worked and paid into Social Security


IS THERE A DEDUCTIBLE FOR MEDICARE PART A?

In 2024, the Part A deductible for an inpatient hospital stay is $1,632. This
deductible is not an annual one; it applies for each benefit period. A benefit
period begins at hospital admission and ends when you’ve been out of the
hospital or skilled nursing facility (SNF) for 60 consecutive days. As a result,
you may have multiple benefit periods requiring payment of the Part A deductible
multiple times in a year.


WHAT WILL I PAY FOR A HOSPITAL STAY IN 2024?

Length of Stay What You Pay Days 1-60  $0 Days 61-90  $408 per day Days 91-150*
 $816 per day

*These are called "lifetime reserve days" because Medicare will only pay for
these extra days once in your lifetime.


WHAT WILL I PAY FOR A SKILLED NURSING FACILITY STAY IN 2024?

Length of Stay What You Pay Days 1-20  $0 Days 21-100  $204 per day After 100
days  All costs


HOSPICE CARE

There is no deductible or copayment for hospice care, only minimal costs for
medications and inpatient respite care.


HOME HEALTH CARE

There is no deductible or copayment for home health care, as long as the
beneficiary meets the eligibility criteria for coverage.


CAN A PROVIDER "OPT OUT" OF MEDICARE? 

Providers can also “opt out” of the Medicare program. That means that they can
charge any amount for a service and will not bill Medicare. If a provider has
opted out of Medicare the full costs of the service must be paid
out-of-pocket; Medicare will not cover any of the costs. Providers that opt out
of Medicare should have signed contracts from beneficiaries stating they consent
to pay the full cost of services.


HAVE QUESTIONS ABOUT YOUR CURRENT MEDICARE PLAN?

Can I change my Medicare plan at any time? What is the highest rated Medicare
Advantage Plan? If you have questions about your Medicare coverage, we want to
help.

Learn more and connect with a licensed Medicare broker that meets NCOA’s
Standards of Excellence. Our brokers are committed to serving your Medicare
selection needs and priorities, including helping you understand all of your
options, at no cost to you.

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