What are the Medicare premiums and coinsurance rates?
The following is a listing of the Medicare premium, deductible, and coinsurance rates that are in effect in 2016:
Part A: (Hospital Insurance) Premium
If you buy Part A, you'll pay up to $411 each month in 2016. But, most people get premium-free Part A. You can get premium-free Part A at 65 if:
- You already get retirement benefits from Social Security or the Railroad Retirement Board.
- You're eligible to get Social Security or Railroad benefits but haven't filed for them yet.
- You or your spouse had Medicare-covered government employment.
If you're under 65, you can get premium-free Part A if:
- You received Social Security or Railroad Retirement Board disability benefits for 24 months.
- You have End-Stage Renal Disease (ESRD) and meet certain requirements.
Part B: (Medical Insurance) Premium
Most people pay the Part B premium of $121.80 in 2016 or higher depending on your income. You pay $166.00 per year for your Part B deductible. After your deductible is met, you typically pay 20% of the Medicare-approved amount for most doctor services (including most doctor services while you're a hospital inpatient), outpatient therapy, and durable medical equipment.
If you don't sign up for Part B when you're first eligible, you may have to pay a late enrollment penalty.
If your modified adjusted gross income as reported on your IRS tax return from 2 years ago (the most recent tax return information provided to Social Security by the IRS) is above a certain amount, you may pay more (Social Security Administration - PDF-12 pages).
Social Security will contact some people who have to pay more depending on their income. The amount you pay can change each year depending on your income. If you have to pay a higher amount for your Part B premium and you disagree (for example, if your income goes down), use this form to contact Social Security (Social Security Administration - PDF-8 pages).
Part D: Costs for Medicare Drug Coverage
You'll make these payments throughout the year in a Medicare drug plan:
- Monthly premium (in addition to your Part B premium)
- Yearly deductible: Deductibles vary between Medicare drug plans. No Medicare drug plan may have a deductible more than $360 in 2016. Some Medicare drug plans don't have a deductible.
- Copayments or coinsurance
- Costs in the coverage gap
- Costs if you pay a late enrollment penalty
Your actual drug plan costs will vary depending on:
- The drugs you use
- The plan you choose
- Whether you go to a pharmacy in your plan's network
- Whether the drugs you use are on your plan's formulary
- Whether you get extra help paying your Medicare Part D costs
Look for specific Medicare drug plan costs, and then call the plans you're interested in to get more details.
If you have limited income and resources, your state may help you pay for Part A and/or Part B. You may also qualify for extra help to pay for your Medicare prescription drug coverage.
For the latest information on Medicare costs and fees, see: http://www.medicare.gov/your-medicare-costs/costs-at-a-glance/costs-at-glance.html.