If you are age 65 or older, you are eligible for the federal health insurance program Medicare. However, certain people younger than 65, can also qualify for this program if they have a disability, ALS ( Lou Gehrig’s disease) or End-Stage Renal Disease (ESRD).
You will be automatically enrolled in the program if you already receive Social Security benefits. So, suppose you do not receive these benefits. In that case, unfortunately, you won’t receive any email notifications that it is time for you to make this decision and enroll in this health insurance program.
What is more, it is very important to enroll in this program on time, so it is advisable to enroll three months before your 65 birthday, and if you have missed that deadline, you have only three months to enroll in the program. If you enroll after that deadline, you will probably need to pay higher premiums.
You can apply online, the application is very easy and takes 10 minutes only to go through it. (1)
What Are The Usual Medicare Costs?
When you enroll for Medicare, you can choose a different kind of Medicare policy, a private insurance plan (Part C) that is offered under the Medicare Advantage program, or a traditional Medicare program (Part A and Part B), so there are different Medicare costs health plans.
The payment for this program depends on the medical needs you have, the eligibility for the financial assistance you need, and the type of Medicare policy you have chosen.
In case you enroll in the traditional Medicare program, you have the possibility to purchase another supplemental insurance policy called Medigap to pay for something that is not covered by the Medicare program because the program doesn’t cover all the medical costs.
So, you will probably need to share costs by paying for some coinsurance, copayments, premiums, and deductibles, and the amount of these additional costs change from year to year. Listed below are the Medicare costs at a glance.
Parts A And Part B Of Medicare
Medical part A (hospital insurance) will pay for hospital inpatient care or for a limited time period spent in a nursing facility after the hospital care. This program can also help you to pay for some hospice care and some other types of health care.
You are eligible for Medical Part A if you have worked or paid Medicare medical taxes for a certain time period.
Medical part B ( medical insurance) can also pay for outpatient care, home care, medical services provided by doctors and other types of health care providers, and medical equipment.
If you pay a monthly premium, you can enroll for Medicare insurance Part B. That is why you may choose not to enroll for this Medicare insurance, but you can choose to sign up every year, during the enrollment period, that is to say, between January 1st and March 31st, and your coverage will begin on July 1st.
Other Parts Of Medicare
Medigap policy pays for other medical costs that are not covered by part A or Part B medical insurances like coinsurance, copayment, or deductible for doctor’s visits or a prescription.
Medicare Advantage Plan – ( it was known as Part C) is a combination of all the services and benefits from both Part A and Part B, along with some other benefits like dental, hearing and vision, and prescription drugs).
Medicare Part D – may help you with coverage of the prescription drugs.
Costs Of Medical Part A
For Part A costs, you do not have to pay a premium if you or your spouse had already paid some Medicare taxes when you worked and most people get these premium benefits- free.
But, if you do not qualify for premium-free Part A, you need to pay the premium of $274 or $499 each month in 2022. This may vary and it depends on the payment you made for the Medicare taxes. You may choose not to buy this insurance policy and buy only Part B.
But, in most cases, patients buy health insurance Part A and pay for:
- Medicare Part B
- Monthly premiums for both Part A and Part B
For Medicare Part A in 2022, if you do not qualify for a premium-free Part A you will need to pay:
|Part A costs:||What you need to pay in 2022|
|Premium||$0 for most people ( if they worked for 10 years and paid Medicare taxes). This is called “premium-free Part A.”|
Otherwise, you can purchase it and it would be $274 or $499 on a monthly basis, depending on the taxes you paid and how long you worked.
In order to purchase Part A, you need to enroll for insurance Part B.
When you turn 65, you need to enroll in this program, if you miss the deadline you will pay a penalty.
|Deductible||$1,556 when hospitalized before Medicare begins to pay.|
|Days 1-60: $0 when your Part A deductible is paid|
Days 61-90: $389 on a daily basis
Days 91-150: $778 on a daily basis when your 60 lifetime reserve days are used
After day 150: All costs are paid
Costs For Medicare Part B Premium in 2022
Most people pay Part B medical insurance, and the standard premium is $170.10 for 2022. In case your gross income is modified as it is reported on your IRS tax return from 2 years ago and is beyond a certain amount, there is an extra charge, and it is added to the premium. So, what Medicare costs you need to pay for 2022 is as follows:
|If your yearly income in 2020 (for what you pay in 2022) was||Medicare costs per month (in 2022)|
|File individual tax return||File joint tax return||File married & separated couple’s tax returns|
|$91,000 or less||$182,000 or less||$91,000 or less||$170.10|
|higher than $91,000 up to $114,000||higher than $182,000 up to $228,000||Not applicable||$238.10|
|higher than $114,000 up to $142,000||higher than $228,000 up to $284,000||Not applicable||$340.20|
|higher than $142,000 up to $170,000||higher than $284,000 up to $340,000||Not applicable||$442.30|
|higher than $170,000 and less than $500,000||higher than $340,000 and less than $750,000||higher than $91,000 and less than $409,000||$544.30|
|$500,000 or higher||$750,000 or higher||$409,000 or higher||$578.30|
When you have enrolled for Part B medical insurance you:
– Pay $0 for any clinical laboratory services
– Pay $0 for home care services
– You have 20 % of the medical amount for durable medical equipment
– Pay 20 % of the Medicare-approved amount for most doctor services like inpatient and outpatient services
– Pay $0 for your yearly depression screening
– If you are hospitalized, you need to pay a percentage of the Medicare-approved amount for each service you get from a doctor or certain other qualified mental health professionals if they accept the assignment.
– After you meet the Part B Deductible, you also pay coinsurance for each day of partial hospitalization services you get in a hospital outpatient setting or community mental health center.
Medicare Part B Premium in 2022 for Higher Incomes
As it is already specified in the table above, the cost for medical insurance Part B is determined by the modified adjusted gross income you make. This means your adjusted gross income plus any tax-exempt interest reported on your most recent tax return.
In turn, people with higher earnings will pay higher prices, and the medical costs for high earners will be automatically higher. For more information about the pay, you can see the table in the previous paragraph.
In addition, if Social Security regards you as a “higher-income beneficiary,” you will pay more for Medicare Part B. However, in some cases, like significant life-changing events ( you lost a job, pension or income-producing property, or divorce), it can be adjusted if you ask the Social Security to do it and help you with Medicare costs.
Costs for Medicare Advantage Plans ( Part C)
Medicare Advantage Plan (Part C) programs are offered by private companies that are approved by Medicare and follow its rules, and most of them include Part D ( insurance plan for drug prescriptions). You can use the Medicare plan finder to find an appropriate plan for you and compare the rules and costs of different types of Medicare Advantage Plans. (2)
Medicare Advantage Plan (Part C) costs may vary depending on the plan you have enrolled in and depends on the following conditions:
- Most plans have a $0 premium. In case you need to pay the premium, this sum will be added to the premium of Part B.
- Some Medicare Advantage Plans offer a reduction of your monthly Medicare Part B (Medical Insurance) premium, and it is called “Medicare Part B premium reduction.”
- The number of deductibles it has ( the payment you need to make for your health care before Medicare starts to pay its share).
- The payment you need to pay for any copayment (the set amount you pay for each medical service, such as a doctor’s visit or prescription) and the coinsurance ( the amount you may be required to pay for services after you pay any deductibles).
- The number of health services you need and how often you use them
- Whether you follow the correct network providers
- Whether you need some extra benefits for which you need to pay some extra charges
- Whether you have Medicaid (a federal and state program that helps with medical costs for some people with limited income and resources ) or you get financial help from the state
The amount for each service, like premium, deductibles and other services, changes, so the amount you pay will probably change every year on January 1st.
The Biggest Changes In Medicare Costs in 2022
Sixty-four million beneficiaries will need to pay higher premiums and deductibles in 2022 compared to Medicare costs in 2021. So Part B will be $170.10 in 2022, up to $21.60 from the 2021 monthly charge. Such a big increase was really necessary, and it was caused by 3 factors:
- 1. The rise in the health care prices, some of which were caused by Covid 19 care
- 2. Due to pandemics, Congress acted to lower the premium increase of Part B, but lawmakers instructed CMS to start paying back the lowered premium starting from 2022
- 3. CMS decided to save money in their reserves in case Medicare starts covering the new drug for Alzheimer’s, Aduhelm. The drug manufacturer cut the price of the drug under the pressure of the drug’s advocates.
The Deductible Rise In 2022
The price for the deductible is also on the rise and is increased by $30 in 2022, and it will be $233.
Medical insurance Part A Cost Change
When it comes to Medical insurance Part A, an increase of $72 is noted compared to 2021, and every patient that is hospitalized must pay $1,556.
Part D Cost Changes In 2022
For Part D, beneficiaries will pay for any prescription drugs at different prices, depending on the plan they choose and the place they live. Still, the deductible cannot exceed $480, and the government does cap the Part D annual deductible.