Original Medicare = Parts A + B

Part AInpatient Hospital Insurance

Part A is funded through taxes that you have paid throughout your career which makes the premium $0 in most cases. Part A has a high deductible of $1,408 and no cap on out of pocket expenses. Services included are skilled nursing care, home health care and hospice care. There are many out of pocket expenses associated with these coverages which makes additional insurance necessary. Luckily, there are plans available with no premium that can strengthen your coverage.

Part BOutpatient Doctor Services

Part B covers outpatient services such as office visits, surgery, radiology labs, emergency room, urgent care, ambulances. For most people the premium is $144.60, but not for all. Please refer to the below chart to see what your premium for 2020 is.

If your yearly income in 2022 (for what you pay in 2024) was You pay each month (in 2023)
File individual tax return File joint tax return File married & separate tax return
$103,000 or less $206,000 or less $103,000 or less $174.70
above $103,000 up to $129,000 above $206,000 up to $258,000 Not applicable $244.60
above $129,000 up to $161,000 above $258,000 up to $322,000 Not applicable $349.40
above $161,000 up to $193,000 above $322,000 up to $386,000 Not applicable $454.20
above $193,000 and less than $500,000 above $386,000 and less than $750,000 above $103,000 and less than $397,000 $559.00
$500,000 or above $750,000 or above $412,000 or above $594.00

Part B has an annual deductible of $198 with 20% coinsurance for approved services. All Medigap policies will require you to pay the deductible before coverage kicks in. You have a seven-month window to enroll in Part B when you are turning 65 starting three months before your birth month, your birth month, and three months after your birth month.  There are steep penalties for late enrollments, so it is important you sign up in your guaranteed eligibility window. Book and appointment so we can help guide you through this process!

Part DPrescription Drug Plans

Part D is a government program for prescription drug plans administered by private insurance carriers. Since Part A and B do not have drug coverage, it is essential that you buy this alongside your Medicare coverages. There is a late enrollment penalty with part D which is why we recommend that you purchase it alongside your other coverages. Advantage plans often include drug coverage so check with your broker about your coverage. Some people will be charged more for their part D. This is called and IRMAA adjustment on your premium bill. See below to see where you fall.

 

Part D drugs plans work similarly to under 65 insurance, but there are differences you will need to discuss with your broker. Plans include drug deductibles and drug tiers. The main difference is the coverage gap also known as the “donut hole”. Essentially once you and the insurer reach $4,020 in costs on prescriptions together then you enter the coverage gap. Once you reach the coverage gap, you will be paying 25% of your drugs costs until $6,350 then you are out of the coverage gap and into the catastrophic phase. Once you are catastrophic the insurer pays then most while you pay a small percentage.

If your filing status and yearly income in 2022 was You pay each month (in 2022)
File individual tax return File joint tax return File married & separate tax return
$103,000 or less $206,000 or less $103,000 or less your plan premium
above $103,000 up to $129,000 above $206,000 up to $258,000 Not applicable $12.90 + your plan premium
above $129,000 up to $161,000 above $258,000 up to $322,000 Not applicable $33.30 + your plan premium
above $161,000 up to $193,000 above $322,000 up to $386,000 Not applicable $53.80 + your plan premium
above $193,000 and less than $500,000 above $386,000 and less than $750,000 above $103,000 and less than $397,000 $74.20 + your plan premium
$500,000 or above $750,000 or above $397,000 or above $81 + your plan premium