Medicare Your Coverage Options

What’s the Medicare premium in 2019?

Written by Diane Archer
The 2019 standard monthly Medicare Part B premiumwhich covers physician services and other medical and outpatient care, will increase from $134.00 to $135.50, up $1.50 a month for people with incomes of $85,000 or less. But, many people with Medicare have been paying less than the standard premium. In 2019, these people may see a $5.50 increase in their Part B premiums.

A “hold harmless” provision in the Social Security Act protects people from paying more in Medicare premiums than the increase in their Social Security monthly benefits from one year to the next. Because Social Security benefits have not increased as fast as the standard Medicare Part B premium, many people with Medicare have not been paying the standard premium. But, Social Security checks are projected to rise by 2.8 percent in 2019. So, people who now pay about $130 a month for the Medicare Part B premium because of the hold harmless provision may no longer be protected from paying the full standard monthly Part B premium.

Since Social Security benefits are increasing 2.8 percent on average in 2019, an average of $39 a monthMedicare monthly premiums can increase up to 2.8 percent –$135.5o a month maximum–for everyone with Medicare who had been protected by the “hold harmless” provision. Put differently, the majority of people who had been paying less than the standard Part B Medicare premium will see their monthly Part B premium rise more than $1.50; but, for most people, their monthly Social Security check, even after the Medicare premium is deducted, should be at least $30 higher than in 2018.

In 2019, 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:

  • $189.60 a month, if their income is above $85,000 and no more than $107,000 ($2.10 increase from 2018)
  • $270.90 a month, if their income is above $107,000 and no more than $133,500 ($3.00 increase from 2018)
  • $352.20 a month, if their income is above $133,500 and no more than $160,000 ($3,90 increase from 2018)
  • $433.40 a month, if their income is above $160,000 and less than $500,000 ($4.40 increase from 2018)
  • $460.50 a month, if their income is above $500,000 ($27.10 increase from 2018)

To arrive at the premium amount for married people filing a joint tax return, double the income.

The 2019 Part B annual deductible is $185, up $2.00 from 2018.

People with incomes up to 135 percent of the federal poverty level, ($1,386 in monthly income for an individual and $1,872 for a couple in 2018; these amounts may increase in 2019) 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 2019 Medicare Part A costs:

  • The Part A hospital deductible is $1,364 and coinsurance for hospitalizations after day 60 is $341 a day in a benefit period; coinsurance for lifetime reserve days  is $682 a day.
  • The Part A daily coinsurance for skilled nursing facility stays after day 20 is $170.50.

Here’s more from Just Care:



  • It should be made clear that although Medicare coverage for Skilled Nursing Facility (SNF) beneficiary cost is $0 for up to 20 days and $170.50 for days 21 through 100 after that for days 101 and beyond all costs are borne by the beneficiary. This is where Long Term Care insurance can be useful. In many states there is some form of partnership arrangement coordinating private insurance with Medicaid to allow people with such plans to qualify for Medicaid without exhausting their life savings.

    • It is true that Medicare only pays for limited nursing home care. Many people with Medicare spend down to qualify for Medicaid, which covers nursing home care. Most people cannot afford long-term care insurance. Many others who buy it end up letting their policies lapse as the premiums become increasingly unaffordable over time. People who want to consider long-term care insurance should speak to an independent expert. Most policies only cover limited expenses for people in limited situations. For more information, you may want to read this Just Care post:

  • I had no idea how subsidized Medicare is for people making high incomes. It doesn’t seem right considering they have the money to pay more for their insurance. But, it does prove the point that America could have Medicare for All. When I say All, I’m referring to people who work.

  • Diane, there are several states that does not allow ‘excess charges’,the 15%, to be charged to Medicare recipients. This is important in both the Advantage and Supplement plans as it can save you money. Part A hospital fees can be extremely high with the excess fees. I think all states should exempt these fee’s for Seniors.

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