2023 Medicare Out-of-pocket Costs
Change is the one thing you can count on in life, and yes, Medicare expenses change too. From year to year, annual deductibles go up slightly, as do:
- Your monthly premiums
- Your coinsurance and copayments for prescription drugs
- Late enrollment penalties (if you missed the enrollment deadline)
- What can you expect this year?
Deductibles for 2023
Here are the details you need to know.
- Medicare Part A will cost $1,600 per benefit period (that starts on admission to a hospital or skilled nursing facility as an inpatient and ends at the termination of care in either facility for 60 consecutive days)
- Medicare Part B will cost $226 per year
- Medicare Part C, or Medicare Advantage, has an annual deductible which may be different, plan to plan. These are offered by private insurers
- Medicare Part D — prescription drug coverage — has an annual deductible which may vary, plan to plan, but cannot exceed $505 per year in 2023. Part D plans are offered by private insurers
2023 Premiums
For Medicare Part A your work and tax history determine whether you pay a premium or not. Here’s how it breaks down:
- As a rule, your Part A premium is waived if you paid Medicare taxes for 10 years, or 40 quarters, while working
- If you paid Medicare taxes working from 30-39 quarters, your premium will be $278/month
- If you paid Medicare taxes working fewer than 30 quarters, you’ll pay $506/month
For Medicare Part B, a monthly premium is standard. In 2023, your Part B premium is $164.90, and for incomes above a set amount, it could be higher. Below a certain amount, it’s possible to qualify for help through a Medicare Savings Program.
For Medicare Part C (Medicare Advantage), premiums vary from plan to plan, and you can even find Medicare Advantage plans costing $0/month. But remember that on top of any premium, you have to pay your Medicare Part B premium.
For Medicare Part D (prescription drug coverage), premiums will vary, plan to plan.
What are my other 2023 Medicare costs?
In addition to deductibles and premiums, coinsurance or copayments are also your responsibility. Your Medicare Part A coinsurance costs look like this:
- $0 coinsurance for the first 60 days of each benefit period
- $400 a day for the 61st to 90th days of each benefit period
- $800 a day for days 91 and beyond per each lifetime reserve day of each benefit period (you get up to 60 lifetime reserve days)
- After lifetime reserve days are used up, you pay all costs
Skilled nursing facility care:
- $0 for days 1 to 20 for each benefit period
- $200 a day for the 21st to 100th days (skilled nursing facility coinsurance of each benefit period)
- Days 101 and beyond, you cover all costs
As far as Part B goes, once your deductible has been met, you’ll generally pay 20% of the Medicare-approved amount for services from a physician, which includes hospital inpatient stays. Outpatient therapy and durable medical equipment will also require a 20% coinsurance payment.
Should I consider a Medigap plan for my Medicare out-of-pocket costs?
A Medicare supplement (Medigap) plan is designed precisely to help fill the gaps in your Parts A and B coverage. You get to find the right one for your particular health and financial needs from among 10 Medigap plans. And because they’re standardized — having the same benefits no matter where you’re buying them — it’s pretty simple to shop for the one you want. Did you know that every plan may pay for an inpatient hospital stay up to a year after exhausting your Medicare benefits? Comparing plans is as easy as entering your zip code and clicking on the free quote button.
Still confused? Call us!
We’re here at 833-245-0614 to answer any questions, and ready to help with any issues you might have with an insurer through the enrollment process.
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FAQs
I’m going to be living on a modest fixed income after I turn 65. What can I expect my Medicare costs to be?
Your basic costs look like this: Deductibles — Medicare Part A will cost $1,600 per benefit period. Medicare Part B will cost $226 per year. Premiums — There is no Part A premium, and the 2023 Part B premium is $164.90. Coinsurance — Your Part A coinsurance is $0 coinsurance for the first 60 days of each benefit period, $400 a day for the 61st to 90th days of each benefit period, $800 a day for days 91 and beyond per each lifetime reserve day of each benefit period (you get up to 60 lifetime reserve days). With Part B, once your deductible is paid you’ll be responsible for 20% of doctor’s costs, including hospital stays.
Is a Medicare Supplement worth it to help pay my out-of-pocket Medicare costs?
This is exactly what they were designed for. A Medigap plan will help you cover gaps in your Part A and Part B insurance, specifically your deductibles, coinsurance, and copayments.
What are the best Medicare supplement plans?
- Best overall Medicare supplement for new enrollees: Plan G.
- Best overall Medicare supplement before 2020: Plan F.
- Best low cost Medicare supplement: Plan K.
- Best alternative to Plan G Medicare supplement: Plan N.
What is a Medicare supplement plan?
Medicare Supplement policies are private health insurance designed to cover gaps in Original Medicare. They are also known as Medigap plans. These take care of costs such as copays, coinsurance, and deductibles which can become expensive if you need regular care from a doctor or hospital. If you need medical care while traveling outside the U.S., you can buy Medigap policies to help cover those costs. As a supplement to Original Medicare, you’re required to have Part A and Part B before you canget a Medigap policy. This way, Medicare is responsible for the Medicare-approved costs of the covered care, and the remainder is covered by your Medigap plan.
What is the most expensive Medicare supplement plan?
Optimal coverage comes with higher costs, making Plan F the most expensive Medigap plan. Plan F is known as “first-dollar coverage” and it takes care of everything provided during a doctor or hospital visit. Your only responsibility is for dental, vision, medications, and equipment, such as hearing aids.
Why is Plan F being discontinued?
The Federal government ended the Plan F option for new enrollees last year to keep the healthcare system from being overused by patients who had their deductibles covered. The next best coverage after Plan F is Plan G.
Is Plan G better than Plan F?
Medigap Plan G offers every advantage of Plan F except for the deductible, which you have to cover. Because it isn’t as comprehensive as Plan F, Plan G is more affordable.
What is the best and cheapest Medicare supplement insurance?
For people who don’t go to the doctor often, Plan K is worth considering. It is the most affordable because it provides just 50% of Medicare Part B coinsurance, the Part A deductible, blood, skilled nursing, and Part A hospice costs. For comparison, Plan G and others offer full coverage of these expenses, and more.
Is Medicare supplemental insurance worth it?
It’s hard to argue against plans which cut your traditional Medicare costs. For most people, having the extra coverage these supplemental plans provide is common sense, unless they want the specific features of a Medicare Advantage plan.
Do I really need supplemental insurance with Medicare?
Most people would benefit from not having to pay out-of-pocket to stay healthy. Medicare supplement insurance or a Medicare Advantage plan offer vital savings now, but are indispensable should a catastrophic health issue occur.
What is the most popular UnitedHealthcare Medicare Supplement plan?
Of the 10 Medicare-approved Medigap plans, Plan G and Plan N are the most popular. Plan F is no longer available to new Medicare enrollees as of 2020, but it is still popular among people who bought this plan prior to 2020.
How much does Medigap insurance cost?
- Plan F$128–$342
- Plan F (high deductible)$22–$88
- Plan G$106–$325
- Plan G (high deductible)$29–$58
Who qualifies for Medigap?
Before getting a Medicare supplement plan, you need to be enrolled in Medicare Part A (hospital insurance) and Part B (medical insurance). People with Medicare Advantage Plans who want to go back to Original Medicare can buy a Medigap policy prior to switching.
Is Medigap insurance worth the cost?
The security of having lower or no out-of-pocket healthcare costs can offset the premiums you’ll have to pay for whichever Medigap plan you choose, which vary depending on the benefits offered.
How Much Is Medigap per month?
The national average cost for Medicare Supplement Plan F is $1,824 annually, which is $152/month; Medigap Plan G will cost you around $143 per month.
Is Plan G the best Medigap plan?
Since Plan F was discontinued for new enrollees as of 2020, Plan G offers the most coverage for people 65 and older. It has a lower premium than Plan F and duplicates its benefits, except for the Part B deductible.
Is it better to have Medicare Advantage or Medigap?
It depends on your specific needs, but for most people a Medigap plan is very useful in supplementing the coverage of Medicare Part A and Part B. A Medicare Advantage plan is an affordable way to get healthcare coverage not offered by Original Medicare.
What is the most popular Medicare supplement plan?
Historically, Plan F has been the most popular because it covers all the out-of-pocket costs Medicare does’t pay for. This includes the 15% extra charge billed by providers who do not take Medicare as full payment.
Does Medigap cover prescription drugs?
Since January 1, 2006, no Medigap policy came with prescription drug coverage. You have two options to get covered, enrolling in either a Medicare Prescription Drug Plan (Part D) or a Medicare Advantage plan.