Each year, new Medicare premiums and deductibles are calculated and published by the Centers for Medicare and Medicaid services (CMS).
Before choosing Medicare Supplement insurance, it is important to understand and know what Original Medicare covers for hospital stays and medical insurance costs, as well as the out-of-pocket expenses that beneficiaries can expect.
Knowing these costs helps you determine what type of Medicare Supplement insurance to choose. Medicare Supplement insurance can help cover some of the costs such as deductibles, co-pays, and other medical costs.
Research Medicare Supplement policies that may fit your insurance needs.
Here is more information that may help you pick a policy.
Medicare Part A for hospital insurance coverage and costs
If you or your spouse have paid Medicare taxes while working, you likely will not be paying any Medicare Part A premium. If you have not paid into the Medicare program, you may pay up to $506 each month. If you don’t enroll in Part A when initially eligible, you might pay a penalty as well.
A benefit period for Original Medicare Part A hospital coverage begins the day you’re admitted as an inpatient in a hospital or skilled nursing facility. The benefit period ends when you haven’t received any inpatient hospital or skilled nursing facility care for 60 days in a row. If you go into a hospital or skilled nursing facility after one benefit period has ended, a new benefit period begins. You must pay the inpatient hospital deductible for each benefit period. There’s no limit to the number of benefit periods in a calendar year.1
For a hospital stay in 2023, you pay:
- $1,600 deductible per benefit period
- $0 for the first 60 days of each benefit period
- $400 per day for days 61-90 of each benefit period
- $800 per “lifetime reserve day” for days 91 and beyond (limited to a maximum of 60 days over your lifetime)
If you’ve been moved to a skilled nursing facility, you pay:
- $0 for the first 20 days of each benefit period
- $200 per day for days 21-100 of each benefit period
- All costs for each day after day 100 of the benefit period
Medicare Part B for medical insurance costs.
Part B monthly premium
Most people pay a monthly Medicare Part B premium. In 2023, the standard monthly premium is $164.90. Premiums are adjusted for Medicare beneficiaries with higher incomes.
Medicare Part B premium is adjusted if either your individual tax return reports income at or above $97,000, or income at or above $194,000 for joint tax returns.
The range for additional premiums begins at $230.80 per month to a maximum of $560.50 a month. The 2023 calendar year Part B deductible is $226 before Original Medicare starts to pay.
The additional premium is based on your IRS tax return two years prior to the current year. If your income has changed significantly, such as the death of a spouse and/or lost income, you can report this to Medicare and ask for an adjustment. Social Security informs you each year the exact amount you will be responsible for.
Medicare Advantage Part C
Medicare beneficiaries can elect to enroll in a Medicare Advantage plan rather than Original Medicare. This plan normally includes Part A, Part B, usually Part D, and occasional chronic care services for qualifying enrollees.
The out-of-pocket costs are different from Original Medicare. Medicare Advantage premiums are in addition to the premiums you pay for Medicare Part B. The maximum allowable out-of-pocket cap for Medicare Advantage has increased from $7,550 in 2022 to $8,300. 3
There are limitations though. Your healthcare services and coverage may be limited to your geographic area and a limited provider network.
Medicare Advantage plans may integrate Part D. If the private insurer you have enrolled with does not, you will be allowed to participate in Medicare Part D.
Medicare Part D for prescription drug insurance costs
If you are signed up for Original Medicare, Medicare Part D is an additional insurance you can buy to help pay for prescription drugs. If you sign up for the Part D during your initial enrollment, you will not be penalized for late enrollment.
Each year Medicare calculates the penalty by multiplying 1% of the national base beneficiary premium times the number of full, uncovered months you didn’t have Part D or creditable coverage. The 2023 Medicare Part D national base beneficiary premium used to determine the Part D penalty is $32.74 per month.
On August 16, 2022, President Joe Biden signed into law the Inflation Reduction Act of 2022, which includes provisions to help limit high-drug costs and help the Medicare beneficiary.4
If you have an income above a certain limit, you pay an income-related monthly adjustment in addition to your Part D plan premium. This changes each year.
Good news regarding drug coverage:
- Insulin costs for the treatment of diabetes has been capped at $35 for a month’s supply.
- All adult vaccines covered under Medicare Part D and recommended by the Advisory Committee on Immunization Practices are now covered in full. This includes the shingles vaccine, the tetanus-diphtheria and whooping cough vaccine.
- Kidney transplant recipients can use Part B immunosuppressive drug coverage for life. Before now, it was limited to 36 months after a kidney transplant.
Medicare Supplement insurance helps cover medical costs
Original Medicare is designed to help with comprehensive health coverage in retirement years, but does not cover all the costs of medical care and hospital stays. Medicare Supplement insurance is available in different types of benefit arrangements to help share the costs of health coverage. Currently, there are 10 plans. Adding Medicare supplement insurance to your Original Medicare Part A and Part B may give you peace of mind. A licensed insurance agent can give you information about the different plans.
Ad # 1303
The purpose of this communication is the solicitation of insurance. United American Insurance Company is not connected with, endorsed by, or sponsored by the U.S. government, federal Medicare program, Social Security Administration, or the Department of Health and Human Services. Policies and benefits may vary by state and have some limitations and exclusions. Individual Medicare Supplement insurance policy forms MSA10, MSB10, MSC10, MSD10, MSF10, MSHDF10, MSG10, MSHDG, MSK06R, MSL06R, MSN10 and in WI, MC4810 and MC4810HD, MC4810HDG are available from our Company where state-approved. Some states require these plans be available to persons under age 65 eligible for Medicare due to disability or End Stage Renal disease (ESRD). You may be contacted by an agent or producer representing United American Insurance Company, PO Box 8080, McKinney, TX 75070-8080. OUTLINE OF COVERAGE PROVIDED UPON REQUEST.
For Ohio, you may verify the agent/broker and United American Insurance Company by contacting: The Ohio Department of Insurance 50 W. Town Street, Third Floor - Suite 300, Columbus, OH 43215. Consumer Hotline: 1-800-686-1526 or TDD Number: (614) 644-3745. For costs and complete details of coverage call or write your insurance agent or the company (whichever is applicable).