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Help Paying for Medicare

Medicare Part A (Hospital Insurance)

Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.

  • Monthly premium:
  • Most people don't pay a monthly premium for Part A (sometimes called "premium-free Part A"). If you buy Part A, you'll pay up to $413 each month in 2017. If you paid Medicare taxes for less than 30 quarters, the standard Part A premium is $413. If you paid Medicare taxes for 30-39 quarters, the standard Part A premium is $227.
  • Late enrollment penalty:
  • If you don't buy it when you're first eligible, your monthly premium may go up 10%. (You'll have to pay the higher premium for twice the number of years you could have had Part A, but didn't sign up.)
  • Part A costs if you have Original Medicare
  • All Medicare Advantage Plans must cover these services. If you're in a Medicare Advantage Plan, costs vary by plan and may be either higher or lower than those in Original Medicare. Review the "Evidence of Coverage" from your plan.
  • Home health care
  • $0 for home health care services.
  • 20% of the Medicare-approved amount for durable medical equipment.
  • Hospice care
  • $0 for hospice care.
  • You may need to pay a copayment of no more than $5 for each prescription drug and other similar products for pain relief and symptom control while you're at home. In the rare case your drug isn’t covered by the hospice benefit, your hospice provider should contact your Medicare drug plan to see if it's covered under Part D.
  • You may need to pay 5% of the Medicare-approved amount for inpatient respite care.
  • Medicare doesn't cover room and board when you get hospice care in your home or another facility where you live (like a nursing home).
  • Hospital inpatient stay
  • $1,316 deductible for each benefit period.
  • Days 1–60: $0 coinsurance for each benefit period.
  • Days 61–90: $329 coinsurance per day of each benefit period.
  • Days 91 and beyond: $658 coinsurance per each "lifetime reserve day" after day 90 for each benefit period (up to 60 days over your lifetime).
  • Beyond lifetime reserve days: all costs.
  • Note: You pay for private-duty nursing, a television, or a phone in your room. You pay for a private room unless it's medically necessary.
  • Mental health inpatient stay
  • $1,316 deductible for each benefit period.
  • Days 1–60: $0 coinsurance per day of each benefit period.
  • Days 61–90: $329 coinsurance per day of each benefit period.
  • Days 91 and beyond: $658 coinsurance per each "lifetime reserve day" after day 90 for each benefit period (up to 60 days over your lifetime).
  • Beyond lifetime reserve days: all costs.
  • 20% of the Medicare-approved amount for mental health services you get from doctors and other providers while you're a hospital inpatient.
  • Note: There's no limit to the number of benefit periods you can have when you get mental health care in a general hospital. You can also have multiple benefit periods when you get care in a psychiatric hospital. Remember, there's a lifetime limit of 190 days.
  • Skilled nursing facility stay
  • Days 1–20: $0 for each benefit period.
  • Days 21–100: $164.50 coinsurance per day of each benefit period.
  • Days 101 and beyond: all costs.

Medicare Part B (Medical Insurance)

Part B helps pay for most doctors' services, outpatient care, medical supplies, and preventive services such as flu shots and vaccines. It also covers most routine medical care as well as emergency medical services.

Medicare Part C (Medicare Advantage Plans)

Part B helps pay for most doctors' services, outpatient care, medical supplies, and preventive services such as flu shots and vaccines. It also covers most routine medical care as well as emergency medical services.

Medicare Advantage Plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans. You must be enrolled in Part A and Part B to join a Medicare Advantage Plan. You are still in the Medicare program, but you will receive your benefits through the plan instead of through Original Medicare. Most Medicare Advantage Plans offer prescription drug coverage. Part C plans musty cover all of the benefits offered by Medicare Part A and Part B. Many plans also provide prescription drug coverage and additional benefits like routine dental, vision, hearing, and gym memberships.

Premiums: Vary by plan. You will still pay your Part B premium, and Part A if you have one.

Deductible: Vary by plans. Part A and B deductibles do not apply

Copayment: Vary by plan. Most plans charge copays for services and benefits.

Coinsurance: Plans set their own coinsurance terms and percentages.