Annual Costs of Medicare B:

This type of Medicare covers your doctor bills.

The standard Part B premium amount is $134 (or higher depending on your income). However, some people who get Social Security benefits will pay less than this amount ($130 on average).

Your monthly out-of-pocket costs: For most people this amount is zero. You most likely won’t have to pay this monthly fee out-of-pocket. For most people your Medicare B is paid out of Social Security. This means that while you won’t see a bill, you will have it deducted from your Social Security. 95% of people pay between $130-$134/mo. (again, deducted from Social Security.) If you have a higher income, you pay more.

MONTHLY PREMIUM:

DEDUCTIBLE:

Deductible:
What you pay when you have to go to the hospital before insurance kicks in.

$183 per year. 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 (dme).

The standard Part B premium amount in 2018 will be $134 (or higher depending on your income). However, some people who get Social Security benefits pay less than this amount ($130 on average). You'll pay the standard premium amount (or higher) if:

  • You enroll in Part B for the first time in 2018.

  • You don't get Social Security benefits.

  • You're directly billed for your Part B premiums (meaning they aren't taken out of your Social Security benefits).

  • You have Medicare and Medicaid, and Medicaid pays your premiums. (Your state will pay the standard premium amount of $134.)

  • Your modified adjusted gross income as reported on your IRS tax return from 2 years ago is above a certain amount. If so, you'll pay the standard premium amount and an Income Related Monthly Adjustment Amount (IRMAA). IRMAA is an extra charge added to your premium.

COINSURANCE

Coinsurance: What you pay out of pocket AFTER you pay the deductible.

  • Days 1-60: $0 coinsurance for each benefit period (Remember the benefit periods are not annual.)

  • Days 61-90: $335 coinsurance per day during a benefit period.

  • Days 91 and beyond: $670 coinsurance per “lifetime reserve” day.

    • You only get 60 of these “lifetime reserve days.”

    • Even we are confused. So what does this mean?

    • Let’s say you are hospitalized for 120 days. You would pay nothing for days 1-60. Day 61-90 you would pay $335 x 30 days or about 10k. For days 91-120 you would pay another $670 x 30 or 20k. AND you will have used up 30 of your “lifetime reserve days.”

    • If the next year you were AGAIN hospitalized for 120 days you would have no more Lifetime reserve days because you only get 60.

    • If the following year you were hospitalized yet AGAIN for 120 days, the last 30 of those days you would pay full pop for the hospital. Yikes.

  • Beyond lifetime reserve days: pay all costs out-of-pocket.