When you sign up for Medicare, you’ll want to think about and budget for your costs each month and when you need services. Your costs will vary depending on which options you choose. If you delay signing up, you’ll have extra costs or penalties once you do.
How Much Will I Pay for Medicare?
If you’re 65 and eligible for retirement benefits from Social Security or the Railroad Retirement Board, you most likely won’t pay a monthly premium for Medicare Part A. Part A covers your hospital insurance. You’ll be eligible for this “premium-free Part A” if you’ve worked long enough. That usually means you or your spouse paid Medicare taxes for at least 10 years.
If you can’t get Part A at no monthly cost, you can choose to pay for it. Check to see what the premium is now. In 2022, the cost for Medicare Part A was up to $499 per month. If you aren’t sure you’re eligible for Part A without a premium, log into your Social Security account to find out. You can also check your W2s or ask your employer.
Most people will pay a monthly premium for Medicare Part B, which covers your outpatient care, such as doctor’s visits. If you’re getting Social Security benefits, the cost for Part B will come out of your payment. If you aren’t getting Social Security, you’ll pay a bill. Most people pay a standard amount. In 2022, the standard monthly premium for part B was $170.10. There is an exception if your yearly income 2 years ago was above a certain amount on your individual or joint tax returns. If it was, you’ll pay a higher monthly amount.
Both Part A and Part B have a deductible you’ll need to meet each year. You’ll also pay coinsurance if you’re in the hospital for an extended time. Under Part B, you’ll usually pay 20% of the Medicare-approved cost for your health care services.
How Much Will I Pay if I Choose Medicare Advantage?
Your costs if you decide to enroll in a Medicare Advantage Plan, also known as Medicare Part C, will depend on which plan you choose. You can search online to see what plans are available to you. You’ll want to read over the plans available to you carefully. Your costs will depend on:
- Your monthly premium, if there is one. If the plan you choose has a premium, you’ll pay it on top of the premium for Part B. Some Medicare Advantage plans also cover part of the Part B premium.
- Your plan’s yearly deductible and any other deductibles.
- Your coinsurance and/or copays when you see a doctor or need other health care services.
- Your health care needs.
- The doctors you see and whether they are in-network.
- Any extra benefits you have and their costs.
- Your plan's yearly limit on how much you’ll pay out-of-pocket for your medical care.
Note that the costs of Medicare Advantage plans are set by the plan. The costs of the plan you choose also may change once a year on Jan. 1. You can shop and switch plans each year during the annual enrollment period, from Oct. 15 to Dec. 7.
How Much Will I Pay for Part D?
If you aren't enrolled in a Medicare Advantage plan or have drug coverage through an employer, you'll also need to enroll in a Part D plan to cover drug costs. Your cost will vary depending on which plan you choose. You can shop for plans available online. Your costs also may be higher based on your income.
Will I Need to Pay Penalties?
If you delay signing up for Medicare, you may need to pay extra. These added costs are late enrollment penalties.
You have 7 months to sign up for Medicare, beginning three months prior to your 65th birthday, the month of your birthday, and three months following your birthday.
For Part A, most people don’t pay any premium. If you’re eligible for this, you won’t pay extra for signing up later. If you need to buy Part A and you didn’t sign up when you first were eligible, your monthly premium may go up by 10%. You’ll pay this higher premium for twice as many years as you didn’t sign up. So, if you delayed 2 years, you’ll pay more each month for 4 years.
If you don’t sign up for Part B when first eligible, you’ll pay an extra 10% premium for each year you waited. For example, if you delayed by 2 years, you’ll pay an extra 20% each month for as long as you have Part B. But you usually won’t pay any penalty if you wait because you or your spouse was working and had health insurance through a job. That’s true as long as you sign up during your 8-month “special enrollment period.”
If you sign up late for Medicare Part D, which covers drug costs, you may also pay a penalty. Your penalty will depend on how long you waited and whether you had “creditable prescription drug coverage” through your job during that time.
Medicare.gov offers questions online to help you understand when to sign up to avoid penalties. Generally, you’ll get signed up automatically if you are getting Social Security benefits. If not, you’ll need to sign up when you turn 65 or when you or your spouse stop working at a job with health insurance benefits.
Where Can I Get Help With My Medicare Costs?
You may qualify for help in paying for your Medicare premiums and other costs. The programs available and requirements will depend on where you live.
- If you have a limited income, you may qualify for Medicaid. State rules vary, so contact your local office to find out if you qualify.
- Depending on income, you may be eligible for a Medicare savings program from your state that helps with monthly premiums. Check to see if you qualify and learn how to apply.
- Some states offer PACE, which stands for Program of All-Inclusive Care for the Elderly. It’s a program to meet people’s needs in their community instead of a nursing home or care facility. PACE covers many services, including dentist, home and hospital care, prescription drugs, and meals.
- There are many ways to lower your prescription drug costs, including choosing generics and mail-order pharmacies. If your income and resources are limited, you may also qualify for a program called Extra Help, which assists with Medicare Part D costs. This program can help with premiums, deductibles, coinsurance, and late enrollment penalties.
If you have Medicare Part A and B, you may want to think about buying Medicare Supplement insurance, or a Medigap plan. These plans help lower your out-of-pocket costs.
Photo Credit: JGI/Tom Grill / Getty Images
Medicare.gov: “Costs for Medicare Drug Coverage,” “Joining a health or drug plan,” “What Does Medicare Cost?” “What’s Medicare Supplement Insurance (Medigap)?” “When Can I Sign Up for Medicare?” “Your Medicare Costs.”