Your Medicare Costs

When you go the official Medicare website which is Medicare.gov, you’ll see on the top that it says sign up and change plans. You don’t want to do that or use me or another insurance agent to help you do those things because you should be managing your costs.

What Medicare covers are the drug plans, Part D supplements, and other insurance, etc. So the site allows you to look at your Medicare cost and get help paying cost.

A lot of people don’t realize that sometimes based on income or other reasons, you can actually get help in paying for Medicare. Remember Medicare Part A has no cost if you worked 40 quarters in your life, but Medicare part B is based on when you got into Medicare and your income.

If you’re at the level where you earn $170,000 as a couple or $85,000 as a single income, then basically you’re paying the lowest Medicare you can.

And this year, it’s $135.50 for Medicare Part B. Now, sometimes people can’t afford those costs. So for that, you have Medicaid which is a joint federal state program that helps with Medicare costs for some people with limited incomes and resources.

Medicare savings programs is a state Medicare savings program. MSP programs help pay premiums, deductibles, coinsurance, copayments, prescription and drug coverage costs. While the PACE program is an all-inclusive care for elderly. It’s a Medicare Medicaid program that helps people meet healthcare needs.

You can also save on drug costs and qualify for extra help for Medicaid to pay for the cost of the Medicare prescription drugs coverage Part D but you’ll need to meet certain income and resource limits to qualify for that.

There are programs for people in the US territory’s programs such as in Puerto Rico, the U.S. Virgin Islands, Guam, northern Mariana islands, and Samoa for people with limited income and resources.

Also, you can find a level of extra help for Part D which is the drug coverage information. Kids now have a children’s health insurance program. They call it Chip or CHP which provides free or low cost health coverage for more than 7 million children under the age of 19. It covers both US citizens and eligible immigrants.

And then there’s SSI or Supplemental Security Income. It’s a monthly benefit paid by social security and is for people with limited incomes and resources who are disabled, blind or aged 65 or older. However, SSI benefits aren’t the same as social security, retirement or disability benefits.

As you go through the site to figure out how to get extra help, you can click on each individual tabs. When you click on the Medicaid tab, a whole lot more information will come up about how that works. It also offers benefits not normally covered by Medicare like nursing home care and personal care services.

So how do you apply for Medicaid? Each state has different rules about eligibility for that so you can call your state Medicaid program and see if you qualify.

You can go through an independent agent and maybe he’ll be able to help you a figure out how to do that. There’s something called Medicaid spend down. Even if you have too much income to qualify, some states will let you spend them and become eligible for Medicaid.

There’s a spend out process where you subtract your medical expenses from your income to become eligible for Medicaid. In this case, you’re eligible for Medicaid because you’re considered medically needy.

But to be eligible as medically needy, your measurable resources must also be under the resource about allowed in your state. So once again, you can call your state Medicaid program to see if you qualify and to learn how to apply.

And then there’s dual eligible. If you have Medicare and Medicaid coverage, most of your health care costs are likely covered. You can get your Medicare coverage through your original Medicare or Medicare Advantage Part C Plan.

If you have Medicare and full Medicaid, you’ll get your Part D Prescription Drugs through Medicare and you automatically qualify for extra help paying for your Medicare prescription drug coverage. The Part D and Medicaid may still cover some drugs in other costs that Medicare doesn’t cover.

So who pays first—Medicare or Medicaid? Medicaid never pays first for services covered by Medicare. It only pays after Medicare employer group health plans as well as for Medicare supplement plans or Medigap plans insurances have been paid.

Once your other insurance is paid, that’s when the Medicaid kicks in. You can see that under the tab “Getting help” and “Paying for costs” which is the Medicaid tab.

Now, let’s get into the Medicare cost. How much is Part A cost premium? You usually don’t pay a monthly premium for Medicare Part A hospital insurance coverage if you or your spouse paid Medicare taxes for a certain amount of time while working. This is called premium-free Part A.

Most people get premium-free Part A at 65 if you’re already getting retirement benefits from social security or railroad retirement board. This means you’re eligible to get social security or wherever it benefits, but just haven’t filed for them yet. This can also apply if you or your spouse have Medicare covered government employment.

If you’re under 65, you can get premium-free Part A if you’ve got social security or railroad retirement board disability benefits for 24 months where you have end stage renal disease, ESRD and these certain requirements.

So if you pay or if you have to buy Part A, you’ll pay up to $437 each month. If you pay Medicare taxes for less than 30 quarters, that’s four quarters a year. Or to get the 40 quarters, you need 10 years of four quarters per year. This is saying that if you have less than 30 quarters, you’re going to pay $437 each month for part A.

Now remember, most people get premium-free Part A and with the standard Part A, the premium is $437. If you paid Medicare taxes ranging anywhere from 30 to 39 quarters, the standard part eight premium would only be $240. And once you hit 40 quarters, it would be zero.

In most cases, if you choose to buy Part A, you must also have a Medicare part B. Medical insurance pay monthly premiums for both part A and part B.

Basically, when you get mailed your Medicare card, if it’s automatically mailed to you because you’re collecting social security, you’ll see it’ll say Medicare Part A on it. And then your card will possibly also say Medicare part B on it. Medicare Part A hospital, Medicare Part B medical and that’s the Part A premium.

When it comes to Part B costs, some people automatically get Medicare part B or medical insurance and some people need to sign up for part B. If you don’t sign up for part B when you’re first eligible for it, you may have to pay a penalty.

Like I just said, there’s probably going to be a late enrollment penalty for Part A if you do it wrong as well as for part B.

But back to the Part B costs. With Part B premiums, you pay a premium each month which will be automatically deducted from your benefit payment. This is if you get benefits from one of these social security railroad retirement board or the office of personal management.

If you don’t get benefit payments, you’ll get a bill. Most people will pay the standard premium . If your modified adjusted gross income is above a certain amount, you may pay income related monthly adjustment amount or an income related monthly adjustment amount (IRMA).

IRMA Medicare uses a modified adjusted gross income reported on your a IRS tax return from two years ago. This is the most recent tax return information provided by social security provided to social security by the IRS.

The standard part B premium for 2019 is $135 and 50 cents. Most people will pay the standard part B premium.

IRMA is an extra charge added to your premium. The chart on the Medicare site says that if your yearly income, for example, in 2017 since it’s currently 2019:

• As a single person was $85,000 or less
• Or if you file a joint return of $170,000 or less
• Or if you’re filed married and separate tax turns in $85,00 or less

You pay in 2018 a total of $135.50 for part B. However, if your income was above $85,000 to $107,000 as a single individual or anywhere from $170,000 to $214,000 as a couple up then you’re going to have to pay $189.64.

If you pay anywhere from $107,000 to $133,500 as a single person or above $214,000 and up to $267,000 as a couple, you would have to pay $270.90 cents for part B.

The next threshold is $352.20 to $433.40. If you’re above $500,000 as a single person or above $750,000 as a couple, you’ll pay $460.50 cents when most people are only paying $135.50 for part B every single month.

That’s the income related adjustment that will be based on your income so you might have to pay more for part B. Now the part B deductible and coinsurance, you pay about $185 per year in 2019 for your part B deductible.

So you have your Medicare card, right? The deductible for part B, you pay the first $185. That’s kind of like when you go see the doctor and then Medicare will kick in after your deductible is met. You typically pay 20% of the Medicare approved amount for these.

Most doctor services include your stay at a hospital as well as inpatient and outpatient therapy plus durable medical equipment. Now that’s if you just have a Medicare card and no other insurance like a Medicare Supplement or Medicare Advantage plan.