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Tag: Premium

  • What are your Medicare premiums in 2025?

    What are your Medicare premiums in 2025?

    Medicare only covers about half of a typical person’s health care costs. People with Medicare generally pay a monthly Medicare Part B premium, about 16 percent of their medical and inpatient costs out of pocket (or through supplemental coverage: Medigap, Medicaid or retiree insurance) as well as some or all of the cost of dental, vision, hearing and long-term care services. Medicare Part B premiums and other out-of-pocket costs are rising in 2025. Here’s what you need to know.

    Part B premiums in 2024:
    In 2025, people whose modified adjusted gross income from two years ago as reported on their federal tax return is $106,000 or less pay a monthly Part B premium of $185, an increase of $10.30.

    People with incomes above $106,000–about eight percent of the Medicare population–pay a Medicare Part B premium of:

    • $259 a month, if their income is above $106,000 and no more than $133,000.
    • $370 a month, if their income is above $133,000 and no more than $167,000.
    • $480.90 a month, if their income is above $167,000 and no more than $200,000.
    • $591.90 a month, if their income is above $200,000 and less than $500,000.
    • $628.90 a month, if their income is $500,000 or more.

    For couples with combined incomes of $400,000 or less two years ago, filing a joint tax return, the premium amount doubles. Couples filing jointly with annual incomes above $400,000 and less than $750,000 each pay a $591.90 monthly premium. And, couples with annual incomes of $750,000 and above each pay a $628.90 monthly premium. Visit this CMS web site for your Part B premium amount if you are filing separate returns.

    Medicare Part B annual deductible: $257, an increase of $17 from the annual deductible of $240 in 2024.

    For more than four decades, the Medicare Part B premium (medical insurance) was the same for everyone regardless of income, geography or health status, a quarter of the cost of Part B services. (Medicare Part A, hospital insurance, is premium-free if you have contributed into Social Security for at least 40 quarters.)  In 2007, wealthier people with Medicare began paying higher premiums.

    Here are 2025 Medicare Part A costs:

    • There is no Medicare Part A premium if you or your spouse are among the 99 percent of people with Medicare who have at least 40 quarters of Medicare-covered employment.
    • The Medicare Part A inpatient hospital deductible is $1,676, in 2025, and  coinsurance for hospitalizations after day 60 is $419 a day in a benefit period; coinsurance for lifetime reserve days is $838 a day.
    • The Medicare Part A daily coinsurance for skilled nursing facility stays after day 20 is $209.50.

    Extra Help paying your Medicare premiums and out-of-pocket costs: People with low incomes and assets have help paying these costs through Medicaid and the Medicare Savings Program. You should apply through your Medicaid office, if you think you might be eligible.

    Here’s more from Just Care:

  • What are your Medicare premium and other costs in 2023?

    What are your Medicare premium and other costs in 2023?

    In 2023, the standard monthly Medicare Part B premium, which covers medical and outpatient care, is $164.90, a monthly decrease of $5.20 from $170.10, for people with annual incomes of $97,000 or less in 2021. At the same time that your Medicare Part B premium is decreasing, your Social Security increase is increasing a 8.7 percent, providing an average additional $146 a month in benefits.

    Social Security benefits in 2023 will be up an average of $1,827 for a single retiree.

    In 2023, people whose modified adjusted gross income from two years ago as reported on their federal tax return–about seven percent of the Medicare population–pay a Medicare Part B premium of:

    • $230.80 a month, if their income is above $97,000 and no more than $123,000.
    • $329.70 a month, if their income is above $123,000 and no more than $153,000
    • $428.60 a month, if their income is above $153,000 and no more than $183,000
    • $527.50 a month, if their income is above $183,000 and less than $500,000
    • $560.50 a month, if their income is $500,000 or more

    For couples with combined incomes of $366,000 or less two years ago, filing a joint tax return, the premium amount doubles. Couples with annual incomes above $366,000 and less than $750,000 each pay a $527.50 monthly premium. And, couples with annual incomes of $750,000 and above each pay a $560.50 monthly premium. Visit this CMS web site for your Part B premium amount if you are filing separate returns.

    Medicare Part B annual deductible: $226, a decrease of $7 from the annual deductible of $233 in 2022.

    For more than four decades, the Medicare Part B premium (medical insurance) was the same for everyone regardless of income, geography or health status, a quarter of the cost of Part B services. (Medicare Part A, hospital insurance, is premium-free if you have contributed into Social Security for at least 40 quarters.)  In 2007, wealthier people with Medicare began paying higher premiums.

    Here are 2023: Medicare Part A costs:

    • There is no Medicare Part A premium if you or your spouse have at least 40 quarters of coverage.
    • The Medicare Part A premium, if you or a spouse has at least 30 quarters of coverage, is $278 a month; if you don’t have at least 30 quarters, the premium is $506 a month.
    • The Medicare Part A inpatient hospital deductible is $1,600, in 2023 an increase of $44 from 2022, and  coinsurance for hospitalizations after day 60 is $400 a day in a benefit period; coinsurance for lifetime reserve days is $800 a day.
    • The Medicare Part A daily coinsurance for skilled nursing facility stays after day 20 is $200, an increase of $5.50 from $194.50 in 2022.

    Extra Help paying your Medicare premiums and out-of-pocket costs: People with low incomes and assets have help paying these costs through the Medicare Savings Program. You should apply through your Medicaid office, if you think you might be eligible.

    People with incomes up to 135 percent of the federal poverty level, (the exact amount will be released in 2023) are eligible for help paying their premiums through Medicaid or a Medicare Savings Program.

    In 2023, for full low-income subsidy (LIS) benefits through the Qualified Medicare Beneficiary (QMB) program, your assets cannot be higher than $9,090 ($13,630 if married). For partial LIS benefits, your assets cannot be higher than $15,160 ($30,240 if married).

    That said, if you notify the Social Security Administration (SSA) that you plan to use some of your assets for burial expenses, for full LIS benefits, your assets can be as high as $10,590 ($16,630 if married). For partial LIS benefits, your assets can be as high as $16,660 ($33,240 if married).

    Here’s more from Just Care:

  • 2023: Medicare Part D prescription drug coverage and costs

    2023: Medicare Part D prescription drug coverage and costs

    Whether you are enrolled in traditional Medicare or a Medicare Advantage plan, Medicare covers the prescription drugs you get from the pharmacy under Medicare Part D. The vast majority of people with Medicare, 49 million in 2022, are enrolled in a Part D drug plan. Here’s what you need to know about Medicare Part D coverage and costs in 2023.

    Don’t assume that your current Part D drug plan will cover your drugs in 2023, even if they did in 2022. Rather, assume that your costs will go up a lot if you didn’t check which Part D plan was likely to save you the most money based on your drug needs, during the Medicare open enrollment period (October 15-December 7). Each year, these private insurance plans can change dramatically. Kaiser Family Foundation reports on your options.

    As a general rule, close to three in four people enrolled in traditional Medicare and a Part D plan will pay higher costs the following year, if they do not look at their options and switch plans.

    In 2023, there are 16 national Part D prescription drug plans, with monthly premiums ranging from $6 to $111. The average premium is $43, up 10 percent from 2022. AARP offers the highest cost Part D drug plan.

    Premiums: Premiums are typically higher for Part D plans offering enhanced benefits, lower cost-sharing and/or low or no deductibles. Standard Part D plans have an average monthly premium of $37. Part D “enhanced” plans that charge no or a low deductible have an average monthly premium of $48 in 2023.

    Standard deductible: The standard and highest possible deductible—the amount you must pay before your coverage begins—is $505.

    If you have traditional Medicare: You typically will be able to choose among 24 Part D drug plans. Depending upon the state you live in, your options range between 19 and 28.

    If you are in a Medicare Advantage plan: You typically will have a choice  of around 35 Part D drug plans.

    Cost-sharing: For non-preferred brand name drugs, coinsurance could be as high as 40-50 percent and as low as $0 for preferred generics, depending upon the Part D plan you choose. You also are likely to pay 15-25 percent coinsurance for preferred brand drugs.

    Typically you’ll pay about $1 for preferred generics and $5 for generics. You’ll pay around $44 copay for preferred brands, 45 percent coinsurance for non-preferred drugs, and 25 percent coinsurance for specialty drugs.

    Costs in each coverage phase: After you have paid your deductible, you are in the initial coverage phase, where you generally will pay around 25 percent of the cost of both brand-name and generic drugs until your drug costs total $4,660. You will then be in the coverage gap phase, where you will be responsible for about 25 percent of the cost of your drugs. Once your out-of-pocket drug costs total  $7,400 in the coverage gap phase, you will be in the catastrophic coverage phase . At that point, you will pay no more than 5 percent of the cost of your drugs or $4.15 for each generic and $10.35 for each brand-name drug.

    If you qualify for a low-income subsidy (LIS) or Extra Help: You will have lower out-of-pocket costs, depending upon the Part D plan you choose and the drugs you use. Around 13 million people with Medicare qualify for extra help with their prescription drug costs. There are 198 Part D drug plans for which you will not pay a premium. You can also choose a “non-benchmark” plan and pay a portion of the monthly premium.

    If you need insulin: The Inflation Reduction Act limits your monthly copayment to no more than $35 in all phases of Part D coverage. However, that limit applies only to insulin in a plan’s formulary, not all insulin products.

    If you need a vaccine: Vaccine costs are covered in full for vaccines that are on the Part D formulary.

    Here’s more from Just Care:

  • 2023: Medicare premiums and other costs

    2023: Medicare premiums and other costs

    The Medicare Open Enrollment period begins on October 15 and ends on December 7, so you will have several weeks to review your Medicare options for 2023. Particularly if you have Medicare Part D drug coverage or are enrolled in a Medicare Advantage private plan–a health plan offered by a corporate health insurance company–reviewing your options could save you a lot of money. Your Medicare Part B premium will be slightly lower in 2023, regardless of whether you are enrolled in traditional Medicare or a Medicare Advantage plan.

    In 2023, the standard monthly Medicare Part B premium, which covers medical and outpatient care, is $164.90, a monthly decrease of $5.20 from $170.10, for people with annual incomes of $97,000 or less in 2021. In addition, you will get a Social Security increase of around nine percent. The exact increase will be announced shortly.

    In 2023, people whose modified adjusted gross income from two years ago as reported on their federal tax return–about seven percent of the Medicare population–pay a Medicare Part B premium of:
    • $230.80 a month, if their income is above $97,000 and no more than $123,000.
    • $329.70 a month, if their income is above $123,000 and no more than $153,000
    • $428.60 a month, if their income is above $153,000 and no more than $183,000
    • $527.50 a month, if their income is above $183,000 and less than $500,000
    • $560.50 a month, if their income is $500,000 or more

    For couples with combined incomes of $366,000 or less two years ago, filing a joint tax return, the premium amount doubles. Couples with annual incomes above $366,000 and less than $750,000 each pay a $527.50 monthly premium. And, couples with annual incomes of $750,000 and above each pay a $560.50 monthly premium. Visit this CMS web site for your Part B premium amount if you are filing separate returns.

    Medicare Part B annual deductible: $26, a decrease of $7 from the 2022 annual deductible of $233.

    If your income is low, you may qualify for help paying your premium and sometimes also your deductibles and coinsurance through the Medicare Savings Programs: People with incomes up to 135 percent of the federal poverty level, ($1,549 in monthly income for an individual and $2,080 for a couple in 2022; these amounts may increase in 2023) are eligible for help paying their premiums through Medicaid or a Medicare Savings Program.

    For more than four decades, the Medicare Part B premium (medical insurance) was the same for everyone regardless of income, geography or health status, a quarter of the cost of Part B services. (Medicare Part A, hospital insurance, is premium-free if you have contributed into Social Security for at least 40 quarters.)  In 2007, wealthier people with Medicare began paying higher premiums.

    Here are 2023 Medicare Part A costs:

    • There is no Medicare Part A premium if you or your spouse have at least 40 quarters of coverage.
    • The Medicare Part A premium, if you or a spouse has at least 30 quarters of coverage, is $259 a month; if you don’t have at least 30 quarters, the premium could be $471 a month.
    • The Medicare Part A inpatient hospital deductible is $1,600, in 2023 an increase of $44 from 2022, and  coinsurance for hospitalizations after day 60 is $400 a day in a benefit period; coinsurance for lifetime reserve days is $800 a day.
    • The Medicare Part A daily coinsurance for skilled nursing facility stays after day 20 is $200.00, an increase of $5.50 from $194.50 in 2022.

    If you have Medicare and are 36 months post kidney transplant, you are no longer eligible for full Medicare coverage. But, beginning in 2023, you can elect to continue Part B coverage of immunosuppressive drugs if you pay a premium. In 2023, the immunosuppressive drug premium is $97.10.

    Medicare Part D premiums

    Premiums for Part D prescription drug coverage vary by income and by Part D plan. The premium is generally deducted from your Social Security check. People with annual incomes at or under $97,000 do not pay an additional income-adjusted premium amount.

    If your annual income is above $97,000, you will be charged between $12.20 and $76.40 a month extra. The extra amount is based on how much higher than $97,000 your income is, with a cap at $750,000.

    Insulin

    Beginning July 1, 2023, you will pay no more than $35 a month out of pocket for insulin. If you take insulin through a pump you get through Medicare, you will have no deductible.

    Here’s more from Just Care:

  • 2022: Health care costs threaten the well-being of many Americans

    2022: Health care costs threaten the well-being of many Americans

    Fewer Americans are uninsured than ever–almost half the number before the Affordable Care Act took effect. But, rates of underinsurance are high, with millions of people having gaps in their coverage, millions skipping care and millions falling into medical debt because they cannot pay their health care bills. The Commonwealth Fund surveyed Americans and found that, too often, health care costs threaten their well-being.

    The big takeaways:

    • More than four in ten adults under 65 (43 percent) did not have adequate health insurance. People without insurance, people with gaps in insurance coverage during the year, and people who could not afford their care are included in this group.
    • Nearly three in ten people with employer coverage (29 percent) and more than four in ten people with coverage they bought in the individual market (44 percent) were underinsured.
    • Close to half of all people (46 percent) said that they had not gotten care or delayed getting care because of the cost. More than four in ten (42 percent) struggled to pay medical bills or were in medical debt.
    • Half of people surveyed (49 percent) said they could not afford to pay an unexpected medical bill of $1, 000 within 30 days, primarily people with low incomes (68 percent), Black adults (69 percent), and Latin/Hispanic adults (63 percent).

    Large numbers believe health care costs should be a top priority for the Biden administration and Congress. Democrats (68 percent), Independents (55 percent), and Republicans (46 percent).

    “Underinsured” is defined for people living above twice the federal poverty level as out-of-pocket health care costs over 12 months, excluding premiums, representing at least 10 percent of household income and for people living under twice the federal poverty level, representing at least 5 percent of household income ($27,180 for an individual and $55,500 for a family of four in 2022). Or, people whose health care deductible represented at least five percent of household income.

    People who lacked health insurance for at least a year tended to be young, poor, with one or more chronic conditions, living in the South, Latin/Hispanic. Undocumented individuals are not able to get affordable coverage.

    Because the US lacks a national health insurance program or even a national health insurance enrollment program, a lot of people who might be eligible for coverage based on their age, income and needs, go without coverage. More than half the people surveyed (56 percent) who had employer coverage but had been uninsured at some point during the year did not know that they were eligible to enroll in their state health insurance exchange plans because they lost their coverage.

    Americans likely would pay a lot less for their health care if the government set rates for all health care providers, as it does for people with Medicare. Because the US does not set provider rates–as all other wealthy countries do–these high rates drive high cost-sharing. Physician and hospital prices in the US are higher than anywhere else in the world.

    Close to one in four people with chronic conditions, such as diabetes, are not filling their prescriptions regularly because of the out-of-pocket cost.

    Of note, nearly one in four people with bills in collection said the bills stemmed from a mistake in billing. More than half of people with medical debt (56 percent) owed at least $2,000.

    Medical bills from out-of-network doctors at in-network hospitals represented almost half of all cost issues. These surprise bills are no longer permissible under the No Surprises Act, which took effect January 2022. But, the survey included a timeframe before then.

    When the public health emergency is declared over, likely in 2023, states will lose their improved federal matching funds. Inevitably, with less money, they will reconsider Medicaid eligibility and restrict coverage.

    Here’s more from Just Care:

  • Biden administration says Part B premiums will drop in 2023

    Biden administration says Part B premiums will drop in 2023

    People with Medicare are paying about $11 a month in extra Part B premiums this year but, next year, everyone with Medicare should see lower Part B premiums according to HealthCareFinanceNews. After factoring the cost of covering Aduhelm, a new exceedingly costly Alzheimer’s drug, into this year’s Part B premium, the Biden administration determined that Medicare would not cover the drug, except in limited circumstances. Still it is not giving people a refund or adjusting the Part B premium until next year.

    Medicare’s projected spending on Aduhelm is responsible for $11 in Part B premiums this year based on the manufacturer’s $56,000 a year launch price and an assumption that Medicare would cover it. Since the Part B premium was calculated, however, Biogen, the manufacturer cut the launch price in half, and Medicare said it would only cover the drug for people in clinical trials.

    The Biden Administration claims it cannot lower the Part B premium this year because of administrative and legal obstacles. Secretary of Health and Human Services, Xavier Becerra said that “After receiving CMS’s report reevaluating the 2022 Medicare Part B premiums, we have determined that we can put cost-savings directly back into the pockets of people enrolled in Medicare in 2023.” “We had hoped to achieve this sooner, but CMS explains that the options to accomplish this would not be feasible.”

    Fierce Healthcare reports that a CMS report goes further: CMS  “does not have sufficient authority to send premium refunds directly to beneficiaries unless there is excess payment relative to the established premium.” If CMS had not considered the cost of Aduhelm in its Part B premium calculation this year, the premium would have been $160.40.

    Because the Centers for Medicare and Medicaid Services factored the cost of Aduhelm into the Part B premium, the 2022 Part B premium is $21.60 higher than it was last year, a 14.5 percent increase.

    Aduhelm has been found to have serious and sometimes even deadly side effects and no clear benefits. The manufacturers of Aduhelm ended two clinical trials because the drug was not helping people. At any price, the drug is likely ill-advised based on the clinical evidence to date. At $27,000, it’s insane.

    Here’s more from Just Care:

  • 2022: Medicare Part D coverage and costs

    2022: Medicare Part D coverage and costs

    Whether you are enrolled in traditional Medicare or a Medicare Advantage plan, Medicare covers your prescription drugs under Medicare Part D. The vast majority of people with Medicare, 48 million in 2021, are enrolled in a Part D drug plan. Here’s what you need to know about Medicare Part D coverage and costs in 2022.

    Don’t assume that your Part D drug plan will cover your drugs in 2022, even if they did so in 2021. Rather, assume that your costs will go up a lot if you don’t change Part D plans. Each year, these private insurance plans can change dramatically. Kaiser Family Foundation reports on your options.

    Red Alert: Nearly three in four people enrolled in traditional Medicare and a Part D plan will pay higher costs if they do not switch plans in 2022.

    There are 16 national Part D prescription drug plans, with monthly premiums ranging from $7 to $99. SilverScript SmartRx is offering a Part D plan with a $7 monthly premium. AARP MedicareRx Preferred is offering a Part D plan with a $99 monthly premium. Wellcare Value Script has lowered its Part D monthly premium for 2022 from $16 to $12 a month.

    Premiums are typically higher for Part D plans offering enhanced benefits, lower insulin costs, lower cost-sharing and/or low or no deductibles. For example, Part D plans that charge no deductible will have an average monthly premium of $90.

    If you have traditional Medicare, you typically will be able to choose among 23 Part D drug plans. The average monthly premium is $43; for standard Part D plans, the average monthly premium is $35, and for enhanced plans it’s $51. Most people (seven in ten) will have an annual deductible of $480, but the average is $384.

    Cost-sharing for brand name drugs could be as high as 40-50 percent and as low as $0 for preferred generics, depending upon the Part D plan you choose. Preferred brand copays will average $42.

    If you are in a Medicare Advantage plan, you typically will have a choice  of 31 Part D drug plans.

    If you qualify for a low-income subsidy or LIS, there are 198 Part D drug plans for which you will not pay a premium.

    Fewer companies are offering Part D drug plans than ever before, which is largely a result of consolidation in the industry. In 2010, 40 companies offered Part D drug plans. In 2022, 16 companies are offering these plans. Four companies control 80 percent of the market, CVS Health, Centene, UnitedHealth and Humana.

    If you need insulin, no matter what state you live in, you can enroll in an Innovation Center Part D plan to lower your insulin costs. You would have a monthly copayment for your insulin of $35 in all phases of Part D coverage. This option is available to everyone who is not eligible for a low-income subsidy or LIS.

    If your income is low and you are among the 13 million people with Medicare who qualify for a low-income subsidy, you have a choice of some premium-free Part D stand-alone plans in 2022. You can also choose a “non-benchmark” plan and pay a portion of the monthly premium.

    Here’s more from Just Care:

  • What are Medicare premium and other costs in 2022?

    What are Medicare premium and other costs in 2022?

    The Medicare Open Enrollment period ends on December 7, so you still have time to review your Medicare options for 2022. Particularly if you have Medicare Part D drug coverage or are enrolled in a Medicare Advantage private plan–a health plan offered by a corporate health insurance company–it could save you a lot of money. Your Medicare Part B premium is rising regardless of whether you are enrolled in traditional Medicare or a Medicare Advantage plan.

    In 2022, the standard monthly Medicare Part B premium, which covers medical and outpatient care, is $170.10, a monthly increase of $21.60 from $148.50, for people with annual incomes of $88,000 or less in 2021. Your Social Security increase should cover that cost and, for most people, provide an additional $70 a month in benefits.

    Social Security benefits in 2022 will be up an average of nearly six percent from this year, around $90 a month. Some of that increase will go towards the higher Medicare monthly premium.

    In 2022, people whose modified adjusted gross income from two years ago as reported on their federal tax return–about six percent of the Medicare population–pay a Medicare Part B premium of:
    • $238.10 a month, if their income is above $91,000 and no more than $114,000.
    • $340.20 a month, if their income is above $114,000 and no more than $142,000
    • $442.30 a month, if their income is above $142,000 and no more than $170,000
    • $544.30 a month, if their income is above $170,000 and less than $500,000
    • $578.30 a month, if their income is $500,000 or more

    For couples with combined incomes of $330,000 or less two years ago, filing a joint tax return, the premium amount doubles. Couples with annual incomes above $340,000 and less than $750,000 each pay a $544.30 monthly premium. And, couples with annual incomes of $750,000 and above each pay a $578.30 monthly premium. Visit this CMS web site for your Part B premium amount if you are filing separate returns.

    Medicare Part B annual deductible: $233, an increase of $30 from the annual deductible of $203 in 2021.

    People with incomes up to 135 percent of the federal poverty level, ($1,456 in monthly income for an individual and $1,960 for a couple in 2020; these amounts may increase in 2021) are eligible for help paying their premiums through Medicaid or a Medicare Savings Program.

    For more than four decades, the Medicare Part B premium (medical insurance) was the same for everyone regardless of income, geography or health status, a quarter of the cost of Part B services. (Medicare Part A, hospital insurance, is premium-free if you have contributed into Social Security for at least 40 quarters.)  In 2007, wealthier people with Medicare began paying higher premiums.

    Here are 2021 Medicare Part A costs:

    • There is no Medicare Part A premium if you or your spouse have at least 40 quarters of coverage.
    • The Medicare Part A premium, if you or a spouse has at least 30 quarters of coverage, is $259 a month; if you don’t have at least 30 quarters, the premium could be $471 a month.
    • The Medicare Part A inpatient hospital deductible is $1,556, in 2022 an increase of $72 from 2021, and  coinsurance for hospitalizations after day 60 is $389 a day in a benefit period; coinsurance for lifetime reserve days is $778 a day.
    • The Medicare Part A daily coinsurance for skilled nursing facility stays after day 20 is $194.50, an increase of $9.00 from $185.50 in 2020.

    Here’s more from Just Care:

  • Coronavirus: Medicare Trust Fund has reserves until 2026

    Coronavirus: Medicare Trust Fund has reserves until 2026

    Every year, Trustees of the Medicare Trust Fund project when the Trust Fund will not have the money needed to pay full Medicare Part A inpatient benefits. Notwithstanding the coronavirus pandemic, their 2021 projection remains the same as last year, 2026. And, Congress could and should act to shore up the Trust Fund.

    A brief Medicare primer. About 63 million older adults and people with disabilities receive health insurance coverage through Medicare. Medicare has two primary funding sources, payroll contributions and general taxes. Payroll contributions cover the cost of Medicare Part A inpatient services. Fewer people used these services in 2020 because of COVID-19.  So, even though fewer people were working and making payroll contributions, Part A remains as strong as last year.

    It’s worth noting that the Medicare Part A Trust Fund has never had its reserves depleted. And, over the last 55 years, the Part A Trust Fund reserves have fluctuated wildly. Back in 2010, Congress gave it a large injection of capital, when it passed the Affordable Care Act and imposed an additional Medicare tax on the wealthiest Americans.

    It’s also important to recognize that if the Part A reserves were to run out, Medicare Part A would still be able to cover 91 percent of projected benefits in 2026. And, if employment rises, payroll contributions will increase. Therefore, it’s more likely that the trust fund will build more reserves.

    Last year, the Part A Trust Fund lost between $60 billion and $134 billion because of loans extended to providers and suppliers to help with COVID-19 payment disruptions. The Trust Fund should get this money back this year and next.

    One critical way to strengthen the Trust Fund is for Congress to stop overpaying Medicare Advantage plans. By one expert account, if Congress does nothing, these plans will be overpaid as much as $355 billion in the next ten years. These overpayments are also driving up Medicare Part B premiums. Congress must trim the fat in Medicare Advantage.

    In addition to the Part A Trust Fund, Medicare has a Supplemental Medical Insurance Trust Fund that covers 75 percent of outpatient care under Medicare Part B. The Medicare Part B premium covers the remaining 25 percent.  And there is a Trust Fund that covers prescription drugs under Medicare Part D.

    The Medicare Part B and D Trust Funds have the money they need to cover outpatient and drug benefits. General revenues cover these expenses, so money never runs out.

    Here’s more from Just Care:

  • What are Medicare premium and other costs in 2021?

    What are Medicare premium and other costs in 2021?

    The Medicare Open Enrollment period ends on December 7, so you still have time to review your Medicare options for 2021. Because the process is not fun, nearly 60 percent of people with Medicare do not review their options. But, particularly if you have Medicare Part D drug coverage or are enrolled in a Medicare private plan–a health plan offered by a corporate health insurance company–it could save you a lot of money. Regardless of whether you are enrolled in traditional or a Medicare private plan, you must pay a Medicare Part B premium.

    In 2021, the standard monthly Medicare Part B premium, which covers medical and outpatient care, is $148.50, a monthly increase of $3.90, from $144.60, for people with annual incomes of $88,000 or less in 2019. Your Social Security increase should cover that cost.

    Social Security benefits in 2021 will be up an average 1.3 percent from this year, around $20 a month. Some of that increase will go towards the higher Medicare monthly premium. Because Congress limited the amount the 2021 standard Medicare Part B premium could rise in Covid-relief legislation earlier this year, most people will have about $16.10 more a month after paying the standard Medicare Part B premium.

    In 2021, people whose modified adjusted gross income from two years ago as reported on their federal tax return–about six percent of the Medicare population–pay a Medicare Part B premium of:
    • $207.90 a month, if their income is above $88,000 and no more than $111,000.
    • $297.00 a month, if their income is above $111,000 and no more than $138,000
    • $386.10 a month, if their income is above $138,000 and no more than $165,000
    • $475.20 a month, if their income is above $165,000 and less than $500,000
    • $504.90 a month, if their income is $500,000 or more

    For couples with combined incomes of $330,000 or less two years ago, filing a joint tax return, the premium amount doubles. Couples with annual incomes above $330,000 and less than $750,000 each pay a $475.20 monthly premium. And, couples with annual incomes of $750,000 and above each pay a $504,90 monthly premium. Visit this CMS web site if you are filing separate returns.

    Medicare Part B annual deductible: $203, an increase of $5 from the annual deductible of $198 in 2020.

    People with incomes up to 135 percent of the federal poverty level, ($1,456 in monthly income for an individual and $1,960 for a couple in 2020; these amounts may increase in 2021) are eligible for help paying their premiums through Medicaid or a Medicare Savings Program.

    For more than four decades, the Medicare Part B premium (medical insurance) was the same for everyone regardless of income, geography or health status, a quarter of the cost of Part B services. (Medicare Part A, hospital insurance, is premium-free if you have contributed into Social Security for at least 40 quarters.)  In 2007, wealthier people with Medicare began paying higher premiums.

    Here are 2021 Medicare Part A costs:

    • There is no Medicare Part A premium if you or your spouse have at least 40 quarters of coverage.
    • The Medicare Part A premium, if you or a spouse has at least 30 quarters of coverage, is $259 a month; if you don’t have at least 30 quarters, the premium could be $471 a month.
    • The Medicare Part A inpatient hospital deductible is $1,484, an increase of $76 from $1,408 in 2020, and daily coinsurance for hospitalizations after day 60 is $371 a day in a benefit period; coinsurance for lifetime reserve days is $742 a day.
    • The Medicare Part A daily coinsurance for skilled nursing facility stays after day 20 is $185.50, an increase of $9.50 from $176 in 2020.

    Here’s more from Just Care: