2019 Medicare Costs: Parts A, B, C, D and Medigap

There are 4 primary parts of Medicare, which include some private Medicare policy options. Another type of private Medicare policy is Medicare Supplement Insurance (also called Medigap).

In this guide, we detail the 2019 Medicare costs for each of the following types of Medicare coverage:

 

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2019 Medicare costs at a glance

There are several types of costs that may be associated with each type of Medicare plan.

  • Premium
    A Medicare premium is the amount that you pay in order to maintain your coverage. Medicare premiums are often paid on a monthly basis.

  • Deductible
    Your Medicare deductible is the amount that you must pay out of pocket for covered services before your Medicare coverage kicks in.

  • Coinsurance
    Coinsurance is the percentage of your healthcare charges that you pay once your deductible is met (example: 20 percent).

  • Copayments
    Copayments are specific amounts you pay for a healthcare service after your deductible is met (example: $20).

Depending on the type of Medicare coverage you have, there may be other costs that you could potentially face. Keep reading to learn more.

A woman reveiws cost information with her doctor and a nurse

Medicare Part A costs in 2019

Medicare Part A is known as hospital insurance and helps cover: 

  • Hospital care
  • Hospice
  • Limited home health services
  • Skilled nursing facility care

Part A premiums

Most people do not pay a premium for Medicare Part A, as long as they or or their spouse paid sufficient Medicare taxes while working.

  • If you paid Medicare taxes for at least 40 quarters (10 years), you do not have to pay a premium for Part A.

  • If you paid Medicare taxes for between 30 and 39 quarters, you will pay a premium of $240 per month in 2019 for Part A coverage.

  • If you paid Medicare taxes for fewer than 30 quarters, your monthly Part A premium will be $437 in 2019.

Part A deductible

Your Part A deductible is the amount you must pay in hospital costs before Medicare begins paying its share.

In 2019, the Part A deductible is $1,364 per benefit period.

Medicare Part A benefit periods are based on how long you’ve been discharged from the hospital:

  • A benefit period begins on the day you're admitted for inpatient care at a hospital, skilled nursing facility or other Medicare-approved facility.

  • Your benefit period resets when you’ve been out of the hospital for 60 days.

  • If you return to the hospital for another visit after 60 days has past, you would have to pay the Part A deductible again because your benefit period reset. 

Part A coinsurance for hospital stays

After you meet your Part A deductible in a benefit period, you will be responsible for daily coinsurance payments for as long as you remain hospitalized:

  • For your first 60 days that you are in the hospital, you pay nothing additional out of pocket for your hospital costs after meeting your $1,364 deductible.
  •  
  • For days 61-90 in a hospital during a single benefit period, you pay a $341 coinsurance in 2019 for each day you are hospitalized.
  •  
  • If you are in the hospital for more than 90 days during a single benefit period, you pay a $682 coinsurance in 2019 for each day you are hospitalized, for up to 60 lifetime reserve days.

Part A coinsurance for skilled nursing facility care

Medicare Part A covers skilled nursing care provided in a skilled nursing facility under certain circumstances. The 2019 Part A coinsurance amounts are as follows:

  • Days 1-20: $0 coinsurance per benefit period

  • Days 21-100: $170.50 coinsurance per day of each benefit period

  • Days 101 and beyond: You are responsible for all costs

Medicare Part B costs in 2019

Medicare Part B is known as medical insurance and helps cover preventive services and medically necessary services that include (but aren't limited to):

  • Clinical research
  • Doctor’s services
  • Ambulance services
  • Limited outpatient prescription drugs
  • Getting a second opinion before surgery
  • Durable medical equipment (DME)

Part B premiums

In 2019, the standard Medicare Part B premium is $135.50 per month.

Most people pay the standard premium amount, but your Part B premium could be higher depending on your income. Some people who get Social Security benefits may pay less.

In 2019, individuals with incomes of more than $85,000 and married couples with incomes of greater than $170,000 have to pay more for their Part B coverage.

This increased amount is called the Medicare IRMAA, or the Income-Related Monthly Adjustment Amount.

The chart below shows what you will pay for your Part B premium in 2019 based on your modified adjusted gross income from two years prior (2017).

Medicare Part B IRMAA
2017 Individual tax return 2017 Joint tax return 2017 Married and separate tax return 2019 Part B premium
$85,000 or less $170,000 or less $85,000 or less $135.50
More than $85,000 and up to $107,000 More than $170,000 and up to $214,000 N/A $189.60
More than $107,000 up to $133,500 More than $214,000 up to $267,000 N/A $270.90
More than $133,500 up to $160,000 More than $267,000 up to $320,000 N/A $352.20
More than $160,000 up to $500,000 More than $320,000 up to $750,000 More than $85,000 up to $415,000 $433.40
More $500,000 More than $750,000 More than $415,000 $460.50

Part B deductible

Your Part B deductible is the amount you must pay in medical costs before Medicare begins paying its share.

In 2019, the Part B deductible is $185 per year.

Part B coinsurance/copayment

After you meet your Part B deductible, you typically pay 20 percent of the Medicare-approved amount for most doctor’s services.

Part B excess charges

Doctors who do not accept Medicare assignment can charge more than the Medicare-approved amount for a service or procedure. The difference between the amount a doctor charges and the Medicare-approved amount is known as an excess charge.

The Part B excess charge can be as much as 15 percent more than the Medicare-approved amount.

Couple looking out of window

2019 Medicare Advantage (Part C) costs

Medicare Advantage (Medicare Part C) is an alternative to Original Medicare that provides the same benefits as Medicare Part A and Part B.

  • Many Medicare Advantage plans may cover prescription drugs

  • Some Medicare Advantage plans also offer coverage for vision, dental and hearing, as well as health and wellness programs such as SilverSneakers to help keep enrollees active and healthy.

  • Starting in 2019, Medicare Advantage plans can offer additional benefits such as transportation to doctor's appointments, grab bars in home bathrooms and healthy meals delivered to your home.

Original Medicare does not cover vision, dental or hearing services that are not considered medically necessary. This includes routine and preventive care.

If you’re enrolled in Original Medicare, you are responsible for 100 percent of the costs related to these services.

If your Medicare Advantage plan includes coverage for prescription drugs, you typically pay a coinsurance or copayment for covered drugs. With Original Medicare, you could pay 100 percent of the costs of many prescription drugs.

Specific prescription drug costs will vary depending on the Medicare Advantage plan you enroll in.

Medicare Advantage out-of-pocket maximum

Medicare Advantage have an out-of-pocket maximum, which limits how much you could pay out of pocket for care in a given year. Original Medicare does not have an out-of-pocket maximum.

The following chart shows how Medicare Advantage coverage and benefits compare to those of Original Medicare.

Original Medicare vs. Medicare Advantage
  Original Medicare Medicare Advantage

Helps cover hospital and medical costs

May cover routine dental care

May cover routine vision care

May cover prescription drugs

Has an out of pocket maximum

Medicare Advantage premiums

Because Medicare Advantage plans are sold by private insurance companies, there is no standard premium like there is with Original Medicare. Premiums may vary according to plan, insurance carrier and location. 

In 2019, the average amount paid for a Medicare Advantage plan was around $29 per month.1

Depending on where you live, there may be Medicare Advantage plans available that feature $0 premiums

Medicare Advantage deductibles

Deductibles for Medicare Advantage plans can vary.

In 2019, the average weighted deductible for a Medicare Advantage plan was around $95 per year.1

Some Medicare Advantage plans may feature $0 deductibles.

2019 Medicare Part D costs

Original Medicare does not generally cover prescription drugs, with the exception of limited outpatient prescription drugs.

If you want Medicare prescription drug coverage, you can enroll in a Medicare Advantage plan that includes drug coverage, or you can enroll in a stand-alone Part D (Medicare Prescription Drug Plan) plan.

Part D premiums

If you enroll in a Medicare Part D plan, you typically pay a monthly premium for your Part D coverage in addition to your Medicare Part B and Medicare Advantage premiums (if applicable).

Part D premiums will differ from one plan, carrier or location to another.

The average premium paid for a Part D plan in 2018 was about $52 per month.1 Some Part D plans may feature $0 premiums.

As with Medicare Part B, some people who earn a higher income may pay a higher premium for their Part D plan. This increased amount is called the Income-Related Monthly Adjustment Amount (IRMA).

The table below shows what you can expect to pay for your 2019 Part D premiums based on your reported income in 2017.

Medicare Part D IRMAA
2017 Individual tax return 2017 Joint tax return 2017 Married and separate tax return 2019 Part D premium

$85,000 or less

$170,000 or less

$85,000 or less

Your plan premium

More than $85,000 and up to $107,000

More than $170,000 and up to $214,000

N/A

You plan premium + $12.40

More than $107,000 up to $133,500

More than $214,000 up to $267,000

N/A

Your plan premium + $31.90

More than $133,500 up to $160,000

More than $267,000 up to $320,000

N/A

Your plan premium + $51.40

More than $160,000 up to $500,000

More than $320,000 up to $750,000

More than $85,000 up to $415,000

Your plan premium + $70.90

More $500,000

More than $750,000

More than $415,000

Your plan premium + $77.40

Part D deductibles

Part D deductibles may vary from one plan to the next.

The average annual Part D plan deductible in 2018 was around $245.1 Some Part D plans may offer $0 deductibles for certain drugs.

Part D coinsurance/copayments

Medicare Part D plans include a drug formulary, which is a list of what drugs the plan may cover.

Medicare plan formularies are divided into tiers. Formulary tiers correspond to how much you might pay in coinsurance or copayments for specific drugs (after you meet your Part D deductible):

  • Low-cost, generic drugs are typically on lower tiers.
  • More expensive and brand name drugs are typically on higher tiers.

Part D donut hole

Medicare Part D plans have a coverage gap, or “donut hole,” which is a temporary limit on how much a Prescription Drug Plan will pay for prescription drug costs.

Here’s how the Part D donut hole works:

  • Part D plans have an Initial Coverage Limit ($3,820 in 2019), which is the total amount you can spend on prescription drugs before entering your plan’s coverage gap.
  •  
  • Once you enter the "donut hole" coverage gap, you may be required to pay a larger portion of your prescription drug costs.
  •  
  • Once you spend $5,100 on prescription drugs in 2019, you will leave the coverage gap and enter catastrophic coverage.
  •  
  • The costs you pay for drugs while in the coverage gap typically contribute to your $5,100 out of pocket total to help get you out of the coverage gap.
  •  
  • With catastrophic coverage, you pay a smaller copayment or coinsurance than you did during the initial coverage phase or while you were in the coverage gap.
  •  
  • Catastrophic coverage remains in effect until the end of the year.

The donut hole will be much less of a factor beginning in 2020. Starting in 2020, Medicare Part D beneficiaries will only pay 25 percent of their brand name and generic drug costs during the coverage gap.

2019 Medicare Supplement Insurance (Medigap) costs

Medicare Supplement Insurance, or Medigap, helps cover some of the out-of-pocket costs that Medicare Part A and Part B don't cover, such as deductibles, coinsurance and copayments.

There are 10 different types of standardized Medigap plans available in most states. The types of costs that different types of Medigap plans are illustrated in the Medigap plans comparison chart below. 

Medicare Supplement Insurance Plans 2019
Medicare Supplement Benefits A B C D F1 G K2 L3 M N4
Part A co-insurance and hospital costs
Part B co-insurance or co-payment 50% 75%
First 3 pints of blood 50% 75%
Part A hospice care co-insurance or co-payment 50% 75%
Co-insurance for skilled nursing facility     50% 75%
Medicare Part A deductible   50% 75% 50%
Medicare Part B deductible                
Medicare Part B excess charges                
Foreign travel emergency     80% 80% 80% 80%     80% 80%
1. Plan F offers a high-deductible plan. This plan requires you to pay a $2,300 deductible in 2019 before it covers anything.
2. Plan K has an out-of-pocket yearly limit of $5,560 in 2019. After you pay the out-of-pocket yearly limit and yearly Part B deductible, it pays 100% of covered services for the rest of the calendar year.
3. Plan L has an out-of-pocket yearly limit of $2,780 in 2019. After you pay the out-of-pocket yearly limit and yearly Part B deductible, it pays 100% of covered services for the rest of the calendar year.
4. Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don’t result in an inpatient admission.
View an image version of this table.

Foreign travel emergency costs

Original Medicare does not typically cover healthcare services received outside of the U.S. and its territories. This means that you are generally responsible for 100 percent of your health care costs while traveling abroad.

Listed below are three exceptions to this rule.

  • You’re in the United States when you have a medical emergency and a foreign hospital is closer than the nearest U.S. hospital.
  •  
  • You live in the United States and a foreign hospital is closer to your home than the nearest U.S. hospital that can treat you for your medical condition.
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  • You’re traveling through Canada “without reasonable delay” by the most direct route between Alaska and another state when a medical emergency occurs and the Canadian hospital is closer than the nearest U.S. hospital.

If you have a Medigap plan that helps cover foreign travel emergency costs, however, you could get help covering some of the costs that Original Medicare would not otherwise typically pay.

Medicare Advantage eligibility and enrollment

Once you’re enrolled in Medicare Part A and Part B, you may be able to enroll in a Medicare Advantage plan.

Speak with a licensed insurance agent to learn more about your options and to compare Medicare Advantage plans in your area.

 

Compare Medicare Advantage plan costs in your area

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Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.