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.
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: 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.