Medicare Parts A&B

Original Medicare

There are two fundamental parts of Original Medicare: Parts A and B.

  1. Part A helps cover:
    • Inpatient care in hospitals.
    • Skilled nursing facility care.
    • Hospice care.
    • Home health care.
  2. Part B helps cover:
    1. Services from doctors and other health care providers.
    2. Outpatient care.
    3. Home health care.
    4. Durable medical equipment (wheelchairs, hospital beds, and other equipment).
    5. Many preventative services (screenings, vaccines, and related services).

 

What are the Costs Associated with Medicare?

Part A

Part A premiums for 2021

Most Medicare beneficiaries don’t pay a monthly premium for Part A (sometimes called “premium-free Part A”) as long as the beneficiary or their spouse worked and paid Medicare taxes for at least 40 quarters. If the beneficiary or spouse paid Medicare taxes for fewer than 30 quarters, the standard Part A premium is $471. If the beneficiary or spouse paid Medicare taxes for 30-39 quarters, the standard Part A premium is $259.

With Part A Hospital Inpatient Deductible and Coinsurance, the Beneficiary Pays:

  • $1,484 deductible for each benefit period.
  • Days 1-60: $0 coinsurance for each benefit period.
  • Days 61-90: $371 coinsurance per day of each benefit period.
  • Days 91 and beyond: $742 coinsurance per each “lifetime reserve day” after day
  • 90 for each benefit period (up to 60 days over your lifetime).
  • Beyond lifetime reserve days: all costs.

Part B

Part B premiums for 2021

Medicare beneficiaries must pay a premium each month for Part B. Their Part B premium will be automatically deducted from their benefit payment if they receive benefits from:

  • Social Security
  • Railroad Retirement Board
  • Office of Personnel Management
  • If they don’t receive these benefit payments, they’ll be billed for the premium.
  • If your modified adjusted income – as reported by their IRS tax return from 2 years before – is above a certain amount, you will pay an Income Related Monthly Adjustment Amount (IRMAA) in addition to their premium.

Part B Deductible & Coinsurance

In 2021, Medicare beneficiaries pay $203 for their Part B deductible. After they meet their yearly deductible, they typically pay 20% of the Medicare-approved amount for the following services:

  • Most doctor services (including those performed while the beneficiary is a patient in the hospital).
  • Outpatient therapy.
  • Durable medical equipment (DME).
  • Ambulance Services.
  • Medicines administered by a Doctor (i.e., Chemotherapy or Injectables).
  • Dialysis.

How to Apply for Medicare

Some beneficiaries receive Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) automatically, while others have to sign up for it. In most cases, it depends on whether or not they’re receiving Social Security benefits.

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