If you, a loved one, or both are nearing the age of 65 the topic of medicare benefits is likely to come up. The goal of the Medicare system as a whole is to make sure seniors have access to affordable health insurance. Understanding the costs of using these benefits will better enable you to properly balance your monthly budget.
While every senior citizen over the age of 65 is entitled to Medicare benefits, there are costs associated with exercising those benefits. This article will primarily discuss the monthly premiums and per-instance costs associated with original Medicare plans. For more information regarding Medicare Advantage Plans read this article which goes more in detail.
Do the benefits outweigh the costs of switching to Medicare?
While Medicare is not free, one can expect to pay considerably less than required by their previous insurance provider.
Seniors can expect to receive equal care under Medicare Parts A and B. this means that they may receive fewer benefits than they did previously.
Nearly half of all Medicare beneficiaries have enrolled in a Medicare Advantage plan to receive additional benefits. These plans are provided by third parties to expand medicare benefits and offer a more traditional insurance company experience
Part A (Hospital Insurance) costs
The majority of Individuals qualify for premium free Part A coverage. Medicare Part A covers costs associated with Hospital visits.
For those who do not qulify for Premium-Free-Part A the premium is either $274 or $499 each month ($278 or $506 in 2023). This dependant on how long you or your spouse worked and paid Medicare taxes. You also have to sign up for Part B to buy Part A. source: Medicare.gov
$1,556 ($1,600 in 2023) for each inpatient hospital benefit period, before Original Medicare starts to pay.
As a Medicare Part A beneficiary you are also required to pay the following costs.
- $389 for each day aft 60 inpatient stay
- $778 copayment each day inpatent while using your 60 lifetime reserve days
- $194.50 for each daySkilled nursing facility stays after 20 days
- 20% of the Medicare-approved amount for durable medical equipment
Medicare Part B Costs
The Part B portion of Medicare covers outpatient care. This includes additional medically necessary services needed to treat a medical disease or condition.
$170.10 each month ($164.90 in 2023) (or higher depending on your income). The amount is subject to change each year.
One Time Deductable
$233 ($226 in 2023), before Original Medicare starts to pay. You pay this deductible once each year.
- As A medicare Part B Beneficieray you may are subject to paying the following:
- Up to 20% of home health care services
- 20% for most doctor services while you’re a hospital inpatient.
- 20% for visits to your doctor or other health care provider
Late Enrollment Penalties
If you don’t buy Medicare Part B when you’re first eligible for Medicare (usually when you turn 65), you might pay a penalty. You can avoid the penalties by enrolling as soon as possible.
Qualified Medicare Beneficiary (QMB) Program
Covers Part A premiums; Part B premiums, deductibles, coinsurance, and copayments (for services and items Medicare covers).
Monthly income and resource limits for 2022:
Eligibility for the Qualified Medicare Beneficiary Program requires one of the following to be true:
- You are a single individual with a monthly income of less than $1153 and resources of less than $8400
- You are a married couple with a combined monthly income of less than $1546 and combined resources of not more than $12600
This program expands on medicares efforts to provide affordable health insurance to all senior citizens including those with low incomes.
We at Meadowcrest Family Physicians recommend our patients enroll in a Medicare Advantage Plan.
After many years of serving Medicare patients, We have found that our patients are getting better benefits with Medicare Advantage Plans and strongly recommend that you explore your Medicare Advantage options. You can be certain that your medicare benefits will be accepted and you will continue to receive the care you deserve.
At Meadowcrest Family Physicians You can be certain that your medicare benefits will be accepted and you will continue to receive the care you deserve. Our commitment to care goes much beyond our office. If you need additional information regarding Medicare Advantage plans we have resources to help. Please make an appointment with our in-office rep to learn your options.