Medicare Costs – 2024
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CMS Announcement – 2024 Medicare Parts A & B premiums and deductibles
Medicare 2024 costs at a glance
This web page lists basic costs for people with Medicare.
Original Medicare Estimated Total premiums per person:
Medicare Part A Premium- $0 (1)
Medicare Part B Premium – $174.70 (2)
Medicare Part D (Prescriptions) Premium Range – $12.30 – $56.80 – $153.70 (in the TN 37701 zip code)
Medicare Supplement (Medigap) Premium Range – $51.00 – $159.00 – $251.00 (Plan D (more coverage/more expensive) or K (less coverage/cheaper) type policies in the TN 37701 zip code)
Estimated Range for Total of Premiums only = $238.00 – $390.50 – $579.40
Medicare Advantage (Part C) Estimated Total premiums per person:
Medicare Part A – $0 (1)
Medicare Part B – $174.70 (2)(3)
Medicare Part D (Prescriptions) – $0 (in this estimate, Part D is included in Medicare Advantage plan)
Medicare Advantage Premium Range- $0.00 – $55.00 – $149.00 (in the TN 37701 zip code)
Estimated Range for Total of Premiums only = $174.70 – $229.70 – $323.70
(1) You could pay a standard Medicare Part A premium of $505.00 if you paid Medicare taxes for less than 30 quarters. If you paid Medicare taxes for 30-39 quarters, the standard Part A premium is $278. Otherwise, there is no premium for Medicare Part A.
(2) “In most cases, if you don’t sign up for Medicare Part B when you’re first eligible, you’ll have to pay a late enrollment penalty. You’ll have to pay this penalty for as long as you have Part B.” In addition, if your modified adjusted gross income as reported on your IRS tax return from 2 years ago is above a certain amount you’ll pay the standard premium amount and an Income Related Monthly Adjustment Amount (IRMAA), which is an extra charge added to your premium.
Medicare Premiums: Rules for Higher-Income Beneficiaries
(3) In some cases some of the Medicare Part B premium may be covered by the Medicare Advantage (Medicare Part C) insurance provider, if you elect to sign up for Medicare Advantage not Original Medicare.
Jump to Medicare Part A Costs
Jump to Medicare Part B Costs
Jump to Medicare Part D Costs
Jump to Medicare Supplement Insurance (Medigap) Costs
Jump to Medicare Part C – Medicare Advantage or Medicare Health Plan Costs
Medicare Part A Costs
This information is based on Medicare/Social Security available information for 2024.
Medicare Part A 2024 costs at a glance
This web page lists basic costs for people with Medicare.
There is no premium for Medicare Part A if you paid Medicare taxes for 40 plus quarters.
There is a deductible, coinsurance and/or co-payment for health services covered by Medicare Part A.
In 2024, if you paid Medicare taxes for less than 30 quarters, the standard Part A premium is $505 ($506 in 2023, $499 in 2022, $471 in 2021, $458 in 2020, $437 in 2019). If you paid Medicare taxes for 30-39 quarters, the standard Part A premium is $278 ($278 in 2023, $274 in 2022, $259 in 2021, $252 in 2020, $240 in 2019).
If you have to pay a premium for Part A and you do not sign up for Medicare in the Initial Enrollment Period, you may have to pay a higher premium for late enrollment in Part A and/or a higher premium for late enrollment in Part B.
You can take a look at obtaining a Medicare Supplemental Policy (Medigap) to cover some of the deductible and/or coinsurance, etc.
Summary for 2024 of Original Medicare Part A hospital inpatient deductible and coinsurance
Medicare Part A Deductible(4) – $1,632.00
Medicare Part A Coinsurance(3) (1-60 days) – $0.00/day (for each benefit period (1))
Medicare Part A Coinsurance(3) (61-90 days) – $408.00/day (for each benefit period)
Medicare Part A Coinsurance(3) (91- plus days) – $816.00/day (for each benefit period up to lifetime reserve days(2))
Medicare Part A – beyond lifetime reserve days: Medicare enrollee is responsible for all costs
(1) A Benefit period begins the day you’re admitted as an inpatient in a hospital or skilled nursing facility. The benefit period ends when you haven’t gotten any inpatient hospital care (or skilled care in a skilled nursing facility) for 60 days in a row. If you go into a hospital or a skilled nursing facility after one benefit period has ended, a new benefit period begins. You must pay the inpatient hospital deductible for each benefit period. There’s no limit to the number of benefit periods. For admissions to general hospitals, Medicare pays a graduated amount from 1 to 90 days, then up to the number of lifetime reserve days. For admissions to skilled nursing facilities, Medicare pays the full amount for the first 20 days, then the patient must pay a $204 co-payment for the next 80 days. After 100 days the patient pays the entire amount.
(2) Lifetime reserve days are the days that you can stay in a general hospital over the 90 days covered by Medicare Part A. As of 2024 Medicare Part A allows for 60 lifetime reserve days that can be used in a person’s lifetime. You do have to pay the coinsurance amount of $816.00/day. Standard Medigap (Medicare Supplement) policies cover an additional 365 lifetime reserve days.
(3) Standard Medigap (Medicare Supplement) policies cover the Medicare Part A coinsurance for lifetime reserve days.
(4) Some Medigap (Medicare Supplement) policies cover all or part of the Medicare Part A deductible.
Medicare Part B Costs
This information is based on Medicare/Social Security available information for 2024.
Medicare Part B costs summary.
Summary of Medicare Part B -Medical – deductible and coinsurance
The Medicare Part B standard premium in 2024 is $174.70 per person ($164.90 in 2023, $170.20 in 2022, $148.50 in 2021, $144.60 in 2020, $135.50 in 2019, $134.00 in 2018).
There is a $240.00 annual deductible in 2024 ($226.00 in 2023, $233.00 in 2022, $203.00 in 2021, $198.00 in 2020, $185.00 in 2019, $183.00 in 2018).
After your deductible is met, you typically pay 20% of the Medicare-approved amount for most doctor services (including most doctor services while you’re a hospital inpatient), outpatient therapy, and durable medical equipment.
Medicare Part B coinsurance and Medigap – Most Medigap (Medicare Supplement) policies cover all or part of the Medicare Part B coinsurance/co-payments.
Medicare Part B deductible and Medigap – Prior to 2020 two types (Plans C and F) of the Medigap (Medicare Supplement) plans also pay the Medicare Part B deductible. Medigap (Medicare Supplement) plans C and F are being discontinued effective January 1, 2020. For those of you who are nearing the age to sign up for Medicare, you may probably want to consider signing up for Plan C or F before they will be discontinued in 2020. However, if you sign up for Plan C or F and choose to keep the plan once it is discontinued, there is no way to know at this time if the premiums will rise too much. Plan G is a good alternative. Plan D might work as well.
The Medicare Part B premium is deducted from Social Security income if you are receiving Social Security benefits, otherwise you will have to arrange for payments.
The standard premium is for individuals with a MAGI of $103,000 or less ($97,000 in 2023, $91,000 in 2022, $88,000 in 2121, $87,000 in 2020, $85,000 in 2019) or less and married couples with a MAGI of $206,000 ($194,000 in 2023, $182,000 in 2022, $176,000 in 2021, $174,000 in 2020, $170,000 in 2019).
MAGI (modified gross income) is your
1) total adjusted gross income as a starting point (for 2023 taxes, usually line 11 on IRS Form 1040) (for 2022 taxes, usually line 11 on IRS Form 1040) (for 2021 taxes, usually line 11 on IRS Form 1040) (for 2020 taxes, usually line 11 on IRS Form 1040) (for 2019 taxes, usually line 8b on IRS Form 1040) (for 2018 taxes, usually line 7 on IRS Form 1040) (for 2017 taxes or earlier, usually line 37/38 on IRS Form 1040)
2) plus some non-taxable items (possibly tax-exempt interest income and non-taxable Social Security),
3) less applicable deductions (possibly self-employed retirement and IRA contributions, half of self-employment taxes paid, health savings accounts or self-employed health insurance payments, and/or student loan interest and qualified tuition costs.).
Medicare Premiums: Rules For Higher-Income Beneficiaries
If your income exceeds
a MAGI of $103,000 for an individual
a MAGI of $206,000 for married couples
then you will pay an additional fee for Medicare Part B.
For 2023 taxes (2024 Medicare), the additional fee could be from $69.90 to $419.30 per person, depending on income.
For 2022 taxes (2023 Medicare), the additional fee could be from $65.90 to $395.60 per person, depending on income.
For 2021 taxes (2022 Medicare), the additional fee could be from $68.00 to $408.20 per person, depending on income.
For 2020 taxes (2021 Medicare), the additional fee could be from $59.40 to $356.40 per person, depending on income.
(For 2019 taxes (2020 Medicare), the additional fee could be from $57.80 to $347.00 per person, depending on income.)
(For 2018 taxes (2019 Medicare), the additional fee could be from $54.10 to $325.00 per person, depending on income.)
(For 2017 taxes, (2018 Medicare) the additional fee could be from $53.50 to $294.60 per person, depending on income.)
Medicare Part B late enrollment penalty
If you didn’t get Part B when you’re first eligible, your monthly premium may go up 10% for each 12-month period you could’ve had Part B, but didn’t sign up. In most cases, you’ll have to pay this penalty each time you pay your premiums, for as long as you have Part B. And, the penalty increases the longer you go without Part B coverage.
Usually, you don’t pay a late enrollment penalty if you meet certain conditions that allow you to sign up for Part B during a Special Enrollment Period. Read more about different situations that may affect when you decide to get Part B. Also you can step through the Check When to Sign Up option to get more information.
Medicare Part D Costs
This information is based on Medicare/Social Security available information for 2024.
You will purchase Medicare Part D (prescription drug coverage) from a private insurer.
You can use the Medicare plan finder tool to obtain a list of prescription drug plans offered in your area. Note, the plan finder gives you an option to find prescription drug plans to use if you are electing the Original Medicare option and options for finding Medicare Advantage (Part C) hmo/ppo plans (not Original Medicare) with or with out prescription drug coverage. If you want to use Original Medicare, then only select the Prescription Drug Plans (with Original Medicare) option.
You can also enter the drugs you are currently taking to see if they are covered, if there are any limitations, and how they might affect your costs.
1) Prescription drug coverage (Medicare Part D) premiums cost estimates average anywhere from $12 to $150 per person per month. The costs can vary depending on where you live.
If your income exceeds
a MAGI of $103,000 for an individual
a MAGI of $206,000 for married couples
then you will pay an additional fee for Medicare Prescription Drug Coverage.
For 2024, the additional fee could be from $12.90 to $81.00, depending on income ($12.20 to $76.40 per person in 2023, $12.40 to $77.90 per person in 2022, $12.30 to $77.10 per person in 2021, $12.20 to $76.40 in 2020, $12.40 to $77.40 in 2019).
Social Security will contact you if you have to pay Part D income-related monthly adjustment amount (IRMAA), based on your income.
MAGI (modified adjusted gross income) is
1) your total adjusted gross income as a starting point (for 2023 taxes, usually line 11 on IRS Form 1040) (for 2022 taxes, usually line 11 on IRS Form 1040) (for 2021 taxes, usually line 11 on IRS Form 1040) (for 2020 taxes, usually line 11 on IRS Form 1040) (for 2019 taxes, usually line 8b on IRS Form 1040) (for 2018 taxes, usually line 7 on IRS Form 1040) (for 2017 taxes or earlier, usually line 37/38 on IRS Form 1040)
2) plus some non-taxable items (possibly tax-exempt interest income and non-taxable Social Security),
3) less applicable deductions (possibly self-employed retirement and IRA contributions, half of self-employment taxes paid, health savings accounts or self-employed health insurance payments, and/or student loan interest and qualified tuition costs.).
Late enrollment penalty on premiums – If you do not sign up for Medicare Part D (prescription drugs) coverage during the Initial Enrollment period, or you don’t have other creditable prescription drug coverage, or do not have any drug coverage for any continuous period of 63 days or more, your prescription drug coverage premium will include an added amount for the late enrollment penalty. This will occur if you are enrolling in a Medicare Part D (prescription dug) plan or if you elect to not go with Original Medicare and enroll in a Medicare Part C (Medicare Advantage) plan.
2) Yearly Deductible – $545 for 2024 ($505 for 2023, $480 for 2022, $445 for 2021, $435 for 2020, $415 for 2019, $405 for 2018). The standard initial deductible is how much you will pay out of pocket before Medicare Part D begins to help cover your costs. No Medicare drug plan may have a deductible more than $545 in 2024 ($505 in 2023, $480 in 2022, $445 in 2021, $435 in 2020, $415 in 2019, $405 in 2018). Some Medicare drug plans don’t have a deductible.
3) Initial coverage limit – $5,030 in 2024 ($4,660 in 2023, $4,430 in 2022, $4,130 in 2021, $4,020 for 2020 , $3,820 for 2019, and $3,750 for 2018). The initial coverage limit marks the point where you would enter the “donut hole”, when you start paying more
4) Coinsurance (percentage) – determined by private insurer (would have coinsurance or co-payment, not both). Coinsurance is a percentage of a service, item, or medication that you must pay.
5) Co-payment (set amount) – determined by private insurer (would have coinsurance or co-payment, not both). A copayment refers to a flat amount that you are required to pay for a particular medical service (such as a visit to the doctor) or prescription drug.
6) Coverage Gap/donut hole – Most Medicare drug plans have a coverage gap (also called the “donut hole”). This means there’s a temporary limit on what the drug plan will cover for drugs. The coverage gap begins after you and your drug plan have spent a certain amount for covered drugs ($5,030 in 2024, $4,660 in 2023, $4,430 in 2022, $4,130 in 2021, $4,020 for 2020, $3,820 for 2019, $3,750 for 2018). The period in which your prescription drug costs have exceeded the initial coverage limit of your plan.
Once you’ve reached this donut hole period, you are responsible for covering the full cost of your drugs (discounted as below).
Thanks to the Affordable Care Act, the coverage gap is shrinking. The coverage gap does not close entirely but it shrinks to where beneficiaries will pay no more than 25% out of their pocket in 2020/2021 and later for generic drugs instead of 44% as in 2018 or 37% in 2019. Beneficiary out of pocket costs for brand name drugs drops to 25% in 2019 and later (one year earlier than generic drugs) instead of 35% in 2018.
When the total cost of your prescription drugs reaches your yearly out-of-pocket spending limit ($8,000 in 2024, $7,400 in 2023, $7,050 in 2022, $6,550 in 2021, $6,350 in 2020, $5,100 in 2019, $5,000 in 2018), you will get out of the coverage gap.
Once the total cost of your prescription drugs reaches your yearly out-of-pocket spending limit, you automatically get “catastrophic coverage.” You will become responsible for just a small percentage of the drug costs.
If you have a Medicare drug plan that already includes coverage in the gap, you may get a discount after your plan’s coverage has been applied to the drug’s price (brand-name or generic).
* Brand-name prescription drugs *
Once you reach the coverage gap in 2019/2020/2021/2022/2023/2024, you’ll pay no more than 25% of the plan’s cost for covered brand-name prescription drugs. 95% of cost will apply to out-of-pocket spending limit because pharmaceutical companies are responsible for 70% of medication cost in the donut hole. You paid 35% in 2018, 85% of the cost applied to out-of-pocket spending limit because pharmaceutical companies were responsible for 15% of medication cost in the donut hole.
* Generic prescription drugs *
Once you reach the coverage gap in 2020/2021/2022/2023/2024, you’ll pay no more than 25% of the plan’s cost for covered generic prescription drugs. You paid 37% in 2019. You paid 44% in 2018.
7) Total out-of-pocket cost (same as yearly out-of-pocket spending limit) – $8,000 in 2024 ($7,400 in 2023, $7,050 in 2022, $6,550 in 2021, $6,350 in 2020, $5,100 in 2019, $5,000 in 2018). Once you are out of the coverage gap/donut hole, you get catastrophic coverage. At that time, you only pay a small coinsurance amount or copayment for covered drugs for the rest of the year.
8) Catastrophic Coverage Costs – Once you get out of the coverage gap (Medicare prescription drug coverage), you automatically get “catastrophic coverage.” It assures you only pay a small coinsurance (percentage) amount or copayment (set amount) for covered drugs for the rest of the year.
Extra Help Program – Medicare and Social Security have a program called Extra Help—a way for people with limited income and resources to get help with prescription costs. Scroll down to the “Apply for Extra Help” link.
If you qualify for Extra Help, you could pay no more than:
In 2024, you pay no more than (up to) $11.20 for brands or $4.50 for generics.
In 2023, you pay the higher of either 5% of retail prices or $10.35 for brands or $4.15 for generics.
In 2022, you pay the higher of either 5% of retail prices or $9.85 for brands or $3.95 for generics.
In 2021, you pay the higher of either 5% of retail prices or $9.20 for brands or $3.70 for generics.
In 2020, you pay the higher of either 5% of retail prices or $8.95 for brands or $3.60 for generics.
In 2019, you pay the higher of either 5% of retail prices or $8.50 for brand drugs or $3.40 for generics.
In 2018, you pay the higher of either 5% of retail prices or $8.35 for brand drugs and $3.35 for generics.
Medicare Supplement Insurance (Medigap) Costs
This information is based on Medicare/Social Security available information for 2024.
A Medicare Supplement Insurance (Medigap) policy helps pay some of the health care costs that Original Medicare doesn’t cover, like Copayments, Coinsurance, and Deductibles.
A Medicare Supplement Insurance (Medigap) policy is purchased separately from a private insurer to supplement your Medicare Part A and Part B coverage.
Some Medigap policies also cover services that Original Medicare doesn’t cover, like medical care when you travel outside the U.S. Medigap policies generally don’t cover long-term care, vision or dental care, hearing aids, eyeglasses, or private-duty nursing.
If you have Original Medicare and you buy a Medigap policy, here’s what happens:
Medicare will pay its share of the Medicare-approved amount for covered health care costs.
Then, your Medigap policy pays its share.
Any standardized Medigap policy is guaranteed renewable even if you have health problems. This means the insurance company can’t cancel your Medigap policy as long as you pay the premium.
Here is a good publication from Medicare covering Medicare Supplement plans (Medigap).
2023 Choosing a Medigap Policy – A Guide to Health Insurance for People with Medicare
There is no comparable 2024 document to be found for Choosing a Medigap Policy.
However, you can go to the Medicare “How to compare Medigap policies” website for information.
You will purchase Medicare Supplement (Medigap) coverage from a private insurer.
Medicare Supplement (Medigap) plan finder.
Medicare Supplement (Medigap) premiums cost estimates average $51 to $843 per person per month. The costs can vary depending on where you live and which plan you choose. In addition, premiums will likely rise each year based on your age, however, premiums can rise based on inflation or other factors. In addition, insurance companies use formularies to determine premium pricing. Refer to the information below for details on the three possible types of formularies. Most insurance companies appear to use the attained-age formulary. However, premium price and annual premium increases will vary by state.
Deductible – Medicare Supplement (Medigap) policies could have an annual deductible, the amount you pay before the Medigap policy starts to pay.
Coinsurance or Co-payment – Medicare Supplement (Medigap) policies could have Coinsurance (percentage) or Co-payments (set amount), which are determined by the private insurer (would have coinsurance or co-payment, not both)
Your out-of-pocket yearly limits – you will need to ask the insurance provider if your out-of-pocket expenses have annual limits. This would mean you pay up to a certain amount each year for covered services and the insurance company takes over and pays all the rest once you reach your out-of-pocket yearly limit.
Maximum payout by Medicare Supplement (Medigap) provider – you will need to ask the insurance provider if there is a maximum the policy will pay out for the covered services. This would mean the insurance company pays up to a certain amount for covered services and you would have to take over if the services cost more than the insurance company maximum payout.
How do insurance companies set prices for Medigap policies?
(Select the “How do insurance companies set prices for Medigap policies?” link for additional information.)
Premiums can rise based on inflation and other factors. In addition, insurance companies use formularies to determine premium pricing. Most insurance companies appear to use the attained-age formulary. However, premium price and annual premium increases will vary by state.
Community-rated (also called “no-age-rated”) – see publication page 17 for more information.
Generally the same premium is charged to everyone who has the Medigap policy, regardless of age or gender.
Your premium isn’t based on your age. Premiums may go up because of inflation and other factors but not because of your age.
Issue-age rated (also called “entry age-rated”) – see publication page 17 for more information
The premium is based on the age you are when you buy (are “issued”) the Medigap policy.
Premiums are lower for people who buy at a younger age and won’t change as you get older. Premiums may go up because of inflation and other factors but not because of your age.
Attained-age rated – see publication page 17 for more information
The premium is based on your current age (the age you’ve “attained”), so your premium goes up as you get older.
Premiums are low for younger buyers but go up as you get older. They may be the least expensive at first, but they can eventually become the most expensive. Premiums may also go up because of inflation and other factors. Most insurance companies appear to use the attained-age formulary. However, premium price and annual premium increases will vary by state.
You must have Medicare Part A and Part B.
Make sure your chosen Medigap plan is portable, in case you want to move.
Medigap policies generally don’t cover long-term care, vision or dental care, hearing aids, eyeglasses, or private-duty nursing.
Helps pay some of the health care costs that Original Medicare doesn’t cover, like Copayments, Coinsurance, Deductibles
Some Medigap policies also cover services that Original Medicare doesn’t cover, like medical care when you travel outside the U.S.
You cannot have (and cannot be sold) a Medicare Supplement (Medigap) policy if you have Medicare Advantage (Medicare Part C)
Medigap Policies are lettered From A to N
Every Medigap policy must follow federal and state laws designed to protect you, and it must be clearly identified as “Medicare Supplement Insurance.” Insurance companies can sell you only a “standardized” policy identified in most states by letters.
All policies offer the same basic benefits but some offer additional benefits, so you can choose which one meets your needs.
Plan C and F were discontinued in 2020. Plans D, G and N appear to be good alternatives.
Each Medigap plan type (A through N) will vary on what is covered.
Plan A has the least coverage.
Plans D, G and N have the most coverage (as of right now).
Medicare Part C – Medicare Advantage or Medicare Health Plan Costs
This information is based on Medicare/Social Security available information for 2024.
Medicare Advantage (Part C) plans are offered through private insurance companies and approved by Medicare. Medicare Advantage Plans are sometimes also called Medicare Health Plans.
Before enrolling in a Part C plan, you must first enroll in Original Medicare — both Part A and Part B.
You’ll get your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage from the Medicare Advantage Plan and not Original Medicare.
Prescription drug coverage when electing Medicare Advantage (Part C) coverage instead of Original Medicare. You will have to look at the topics that are about Medicare Advantage with Drug Coverage. If you are electing to use Original Medicare with a Drug Plan, that will not apply to anyone with a Medicare Advantage (Part C) plan.
Most Medicare Advantage Plans include prescription drug coverage (Medicare Part D). It appears that if you elect to use a Medicare Advantage plan and you want drug coverage, you should get a Medicare Advantage plan that includes drug coverage.
If your Medicare Advantage plan does not offer prescription drug coverage and you want to add drug coverage, it appears you may have to change Medicare Advantage plans.
It is possible that you cannot purchase a separate Medicare Part D – Prescription Drug Coverage when using Medicare Advantage.
If you do not sign up during the initial signup period there may be a penalty and it may cost more.
There may be limitations on coverage areas.
There may be limitations on provider (doctors, hospitals, etc.) selection.
You may need to use health care providers who participate in the plan’s network.
You will purchased Medicare Advantage (Part C) from a private insurer.
Medicare Plan Finder
You do not have to Log In to find a Medicare Advantage Plan. You can select the “Continue without logging in” option.
You’ll type in your Zip Code to proceed, when not logging in.
You’ll specify what type of plan you are looking for, e.g. Medicare Advantage (Part C), Medicare Drug Plan (Part D), or Medigap policy only.
There will be a few more questions before you can continue,
e.g. 1) Do you get help with your costs from one of these programs? 2) Do you want to see your drug costs when you compare plans? You can elect to not add drugs at this time or you can add your drugs to get an idea how your drugs are covered by the plans found for you in your area.
Finally, you can see the available Medicare Advantage Plans with and without drug coverage.
You can review the “Select a Plan Type” drop down option to ensure you have “Medicare Advantage selected. There are additional filter options using the drop-downs options for Plan Benefits, Insurance Carrier (insurance company), Drug Coverage, and Star Ratings.
Medicare Advantage (Medicare Part C) coverage costs:
Premium – A premium of $0.00 or more depending on selected standard Medicare Advantage premium, per person. I found plans up to $167.00 per month per person in my area. This was a BlueCross BlueAdvantage Diamond PPO plan. PPO plans may be less restrictive on your choices of hospitals and providers than HMO plans. I received 38 results for Medicare Advantage plans in my area. Fourteen (14) of the results were for PPO plans and there were two Regional PPO plans) with a premium range of $0.00 to $167.00 The remaining twenty-four (24) were HMO plans with a monthly premium range of $0.00 to $107.00. You would really have to dig deep to determine if one plan is actually better than another and if the plan will meet your needs.
Medicare Part A – Premium is at no cost unless you exceed the income limits or you did not work enough to qualify for no cost premium or if you did not sign up during the Initial Enrollment Period.
Medicare Part B – The Medicare Part B standard premium is $174.70 per person, unless you exceed the income limits or you did not sign up during the Initial Enrollment Period. Some Medicare Advantage (Medicare Part C) plans used to pay the Medicare Part B premium as part of the coverage. However, as of 2024, in my zip code, not one plan covers the Medicare Part B premium.
Health Deductibles – Yes or probably. Health Service Deductibles were from $3,200 to $6,700 in my zip code. Deductibles are higher if services are out-of-network.
Drug Deductibles – Yes or probably. Make sure the policy has drug coverage. Drug Deductibles were from $0 to $545 in my zip code.
Co-payments – Yes or probably
Coinsurance – Yes or probably
Out of pocket spending limit – Yes or probably. Can be different for in network vs out-of-network.
Many Medicare Advantage Plans also offer extra coverage, like vision, hearing and dental coverage. You’ll have to ask and determine exactly what is the coverage and how much. E.g. for vision: does it cover check ups? does it cover optometrists, ophthalmologists? does it cover extended check ups? does it cover frames and/or lenses? Etc. E.g. for dental: does it cover check ups? does it cover fillings? does it cover crowns? Etc.
Switching or dropping Medicare Advantage. Scroll down to the topic that addresses what you want to do, e.g. switch or drop Medicare Advantage. Be very careful when researching these options. You do not want to lose whatever coverage you have or end up paying a lot more for different coverage.
If you want to switch to Original Medicare and buy a Medigap policy, contact your Medicare Advantage Plan to see if you’re able to disenroll or contact Medicare at 1-800-633-4227 (1-800-MEDICARE).
If you join a Medicare Advantage Plan for the first time, and you aren’t happy with the plan, you’ll have special rights under federal law to buy a Medigap policy, if you return to Original Medicare within 12 months of joining.
Guaranteed issue rights (also called “Medigap protections”) (Scroll down to the “What are Guaranteed issue rights? link)are rights you have in certain situations when insurance companies must offer you certain Medigap policies. Thus allowing you to return to Original Medicare and drop the Medicare Advantage Plan.
Refer to the Medicare Enrollment Periods topic for additional information on switching Medicare Advantage plans or dropping your Medicare Advantage plan to return to Original Medicare and adding Medicare Part D (prescription drug coverage) and adding a Medicare Supplement (Medigap) plan.
You can also contact Medicare direct at 1-800-633-4227 (1-800-MEDICARE) for assistance.
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