We’ve often discussed Medicare costs … particularly, the deductibles, copays, coinsurance charges, and premiums someone might expect to pay for the various Medicare parts and plans.
This time let’s try to determine how much a Medicare recipient might expect to pay in total for comprehensive health coverage.
Original Medicare
Chances are you don’t have to pay any premiums for Part A (hospital) coverage. The vast majority of Medicare recipients have premium-free Part A coverage because they covered the cost of these premiums over the course of their working years, or because they are related to a primary Medicare claimant (such as a spouse) who covered the cost of Part A premiums while working. For the small number of Americans required to pay Part A premiums, the monthly cost is currently set at $441.
Your Medicare Part B (medical) premium is probably set at $104.90 per month. However, if your 2011 income exceeded $85,000 ($170,000 for joint filers), your Part B premium is somewhere between $146.90 and $335.70 per month.
Even if you’re in the best of health, you can expect to pay your $147 Medicare Part B deductible. You can also expect to pay a 20 percent coinsurance on Part B-covered charges—which can add up fast!
Whether you have to pay any or all of your Medicare Part A deductible depends largely on your health and your luck—and particularly on your ability to avoid hospitalization. The Medicare Part A deductible is currently set at $1,184—an amount some people have to pay more than once a year.
Out-of-pocket hospital costs will not exceed the deductible amount during a hospital stay of 60 days or less, anyone unfortunate enough to stay in the hospital longer than 60 days can expect to see costs skyrocket starting on the 61st day.
Assuming you’re in good health and manage to avoid hospitalization, you’re probably looking at a monthly cost of $147 plus Part B coinsurance for your Original Medicare coverage.
But that’s really a best-case scenario—and we all know how foolish it can be not to be prepared for the worst case.
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Additional Coverage to Consider
Medicare Part C plans—also called Medicare Advantage plans—are optional Medicare plans offered by Medicare-approved private companies and available to people already enrolled in both Medicare Part A and Medicare Part B.
If you enroll in a Medicare Advantage plan, your plan will provide all of your Medicare Part A and Part B coverage. Medicare Advantage plans can also provide additional coverage in other areas of health including dental, vision, and hearing. Most Medicare Advantage plans also include prescription drug coverage.
Although every company offering Medicare Advantage plans has to follow rules set by Medicare, companies retain a lot of flexibility when it comes to setting out-of-pocket cost requirements and rules establishing which doctors or facilities you can use and when. In these areas companies can set their own policies, and the policies can change from year to year.
The amount you are likely to pay for Part C coverage depends on so many variables that it is hard to give a general rule. There are supposedly premium-free Medicare Advantage plans that impose other, often unexpected, charges on people enrolled in the plans. Some plans, meanwhile, charge reasonable monthly premiums for coverage that exceeds what Medicare Part A and Medicare Part B cover.
Anyone considering Medicare Advantage needs to be aware of all cost obligations before enrolling. For help choosing a Medicare Advantage plan that can help eliminate many out-of-pocket costs associated with Original Medicare, call MedicareMall toll-free at (877) 413-1556.
Enrollment in a Medicare Advantage HMO with prescription drug coverage may set you back as little as about $40 a month. Depending on the plan, you might be responsible for a $25 copay each time you visit your doctor. If you are in generally good health and visit the doctor about four or five times a year, that means monthly costs associated with your Part C plan will average about $50 a month. That sounds like a great deal—but remember, you have to know exactly what you’re getting into when you enroll in a Medicare Advantage plan.
Choosing the right plan can be a godsend—just as choosing the wrong plan can be a headache you can’t shake off. Remember, nobody scours and shops the market on your behalf better than MedicareMall.
Medicare Part D plans offer prescription drug coverage. With the high cost of prescription drugs, many Medicare recipients find Part D prescription drug plans (PDPs) an essential tool for keeping drug costs within their budget. As we’ve already discussed, prescription drug coverage is available through most Medicare Advantage plans. But for people not enrolled in Medicare Advantage, there are stand-alone PDPs available at reasonable cost.
For enrollment in a Part D prescription drug plan, you can expect to pay a premium of between $20 and $60 a month. Most PDPs also come with a yearly deductible of $320 and copayment or coinsurance charges that continue until you and your plan pay a combined total of $2,930 for your drug costs. After that comes the notorious donut hole phase.
Fortunately, Medicare supplement (or Medigap) plans can put to rest many of the concerns you may have about out-of-pocket obligations associated with Medicare.
Medigap plans, sold by private insurance companies to people already enrolled in Medicare Parts A and B, are designed to help fill the gaps in Original Medicare coverage. There are ten different Medigap options spanning the alphabet from Medigap Plan A all the way to Plan N.
If you’re serious about sticking to your budget, one Medigap plan you’ll definitely want to check out is the highly popular Plan F, designed to fill all the high-risk gaps in basic Medicare coverage. With Plan F you won’t have to worry about paying one penny out of pocket for any Medicare-approved hospital or medical costs including deductibles, copayments, and coinsurance charges. Plan F covers all Medicare-approved costs not covered by Medicare Part A and Medicare Part B.
Although insurance companies offering the same Medigap plans have to offer the same benefits, companies are free to apply their own pricing and underwriting practices, so it’s important to shop the market before choosing a plan. Remember, nobody does that better on your behalf than MedicareMall, and nobody makes it easier to choose the best Medicare supplement plan to meet your particular needs.
Some Medicare supplement plans are available for well under $100 per month. Even for comprehensive coverage under Plan F, costs are far less than most people think. For example, a 67-year-old male nonsmoker in living in Tulsa, Oklahoma, can pay as little as $126.16 a month for Plan F coverage, while a 66-year-old female nonsmoker can pay as little as $117.41.
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And the total …
Since you can’t get much better coverage than Original Medicare bolstered by a comprehensive Medicare supplement plan such as Medigap Plan F and a Part D prescription drug plan, let’s do the computing:
Medicare Part A premium = $ 0 (for the vast majority of people)
Medicare Part B premium = $104.90 (for most people)
Medigap Plan F premium = $120 (more or less, if you shop the market)
Medicare Part D premium= $ 20 (if you shop the market)
Total = $244.90 per month
Keep in mind that coverage that includes Medigap Plan F will help keep out-of-pocket costs to a minimum. There may be a better coverage combination to meet your individual needs, and MedicareMall can help you determine whether that is the case.
Keep in mind also that quitting tobacco use can help ensure you get the lowest rates possible. And a healthy diet and plenty of exercise will often ensure you keep your healthcare needs—and costs—as low as they can be.
To learn more about getting the best possible health coverage at the very best price, contact MedicareMall today!
How do you keep your Medicare costs low? Leave a comment below!
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