If you are about to turn 65, you may have questions about Medicare costs.
The amount of out-of-pocket costs you will pay depends on the coverage options you choose and what kind of healthcare services and benefits you use throughout the year. Each year there are always changes to Medicare benefits and here are some of the most recent costs you may be responsible for this year.
Medicare Part B: Medical Insurance
Part B helps pay for health care services such as doctor services, preventive benefits, hospital outpatient surgery and care, ambulance services, outpatient mental health services, durable medical equipment, and home health care (not covered by Part A).
You pay a premium each month for Part B. Your Part B premium will be automatically deducted from your benefit payment if you get benefits from one of these:
Railroad Retirement Board
Office of Personnel Management
If you do not get these benefit payments, you will receive a bill.
Part B Premium: In 2022, most beneficiaries will pay $170.10/month for Part B. The premiums and coinsurance amount for Original Medicare Part A and B services in 2022 have increased. In 2021, the Social Security Cost of Living Adjustment (COLA) was 1.3%. In 2022, the COLA will be 5.9%. However, there are scenarios in which beneficiaries may pay less or more than this amount.
Beneficiaries subject to the "hold harmless" provision whose Social Security checks will not increase enough to cover the $170.10 premium:
The hold harmless provision in federal law protects Medicare beneficiaries in two ways:
Part B premiums cannot increase in years when there is no Social Security Cost of Living Adjustment (COLA).
The net Social Security benefit cannot be lower than the previous year's benefit amount.
Beneficiaries with higher incomes: Persons with higher incomes will pay for Part B, according to the Income Related Monthly Adjusted Amount (IRMAA) schedule. IRMAA applies to individuals whose modified adjusted gross income on their 2020 tax returns is as follows:
More than $91,000 per individual or $182,000 for a couple, you could pay as much as $238.10 per month for Part B premiums.
Other Costs in Part B
In addition to the Part B premium, there are out-of-pocket costs beneficiaries pay when they receive services covered by Medicare Part B. These costs, like the Part B premium, can change each year.
Part B Annual Deductible: The deductible is the annual amount you pay for covered services & care before Medicare starts to pay. The Centers for Medicare & Medicaid Services recently released the 2022 Medicare Part A deductible ($1,556) and Part B deductible ($233).
After the deductible has been paid, Medicare pays most (generally 80%) of the approved cost of care for services under Part B, while people with Medicare pay the remaining cost (typically 20%) for services such as doctor visits, outpatient therapy, and durable medical equipment (e.g., wheelchairs, hospital beds, home oxygen equipment, diabetes supplies).
Help with Medicare costs There are four programs that can help Medicare beneficiaries with limited incomes pay for their Medicare coverage. These programs are called Medicare Savings programs (MSP.) MSPs are a set of benefits that are administered by state Medicaid agencies that help people pay for their Medicare Part A & B costs. MSPs are divided into several programs:
· The Qualified Medicare Beneficiary (QMB)
· Specified Low-Income Medicare Beneficiary (SLMB)
· Qualifying Individual (QI)
· Qualified Disabled Working Individual (QDWI)
By using the Federal poverty guidelines released each January, this updated eligibility chart with state-specific information about the income and resource thresholds for the four Medicare Savings Programs can help low-income Medicare beneficiaries pay their healthcare costs.
To find out more information about Medicare Costs and eligibility guidelines for programs to help lower your Medicare monthly cost, contact our certified benefits counselors Angela Glass and/or Vonne Wilson at The Ark-Tex Area Agency on Aging for assistance. The number is 1-800-372-4464. We look forward to hearing from you!