2019 Medicare Costs

  • 2019 Medicare Costs

    In 2019 the Medicare costs are as follows:

    Part A: Medicalization.

    • Premium: $437.00 a month.
      • Many people qualify for a premium free benefit of Part A as they have paid taxes for it while working.
    • Deductible: $1,364.
    • This is for each benefit period that occurs.
    • Example – Person A is admitted for a medical procedure as an inpatient, there is a deductible for this occurrence. If Person A is again admitted for a different occurrence, then there will be another deductible that must be paid.
    • Hospital Stays:
    • Days 1-60: $0.00. For each occurrence
    • Days 61-90: $341.00 per day.
    • Days 91 and beyond: $682.00 per day, up to 60 days.
    • Skilled Nursing
    • Days 1 – 20: $0.00.
    • Days 21 – 100: $170.50 per day
    • Days 101 and beyond: All costs

    Note: With certain Supplemental Plans (Medigap) the ability to cover all costs of Part A can be achieved as well as extending the number of Hospital Stays to 365 days per year.

    Part B: Physician Coverage

    • Premium: $135.50 a month
    • Deductible: $185.00 per year
    • Excess charge: 15%.
      • This charge is for healthcare providers who do not participate in the Medicare program. If they do tend to a Medicare beneficiary, they can charge up to 15 percent of the Medicare cost.

    Note: With certain Supplemental Plans (Medigap) the ability to cover the deductible and the excess charge of Part B can be achieved.

    Income Related Monthly Adjustment Amount (IRMAA).

    IRMAA applies to people with higher incomes who are enrolled in Part B and/or covered under a Medicare Part D Prescription Drug Plan. For those who enter Medicare’s IRMAA there will be a surcharge on top of their monthly Medicare Part B and Part D premiums.

    2019 IRMAA Brackets:



    Note: Social Security benefits will automatically pay these IRMAA surcharges. A Medicare beneficiary will receive a bill if they are receiving Social Security.

    Part D: Prescription Drug Coverage.

    • Premiums: $46.95 per month.
    • This premium is based on a national average and is combination of plans that also include a deductible.
    • The price of the premiums varies by residency, medications within the plan and by the insurance company that administers the plan.
    • If part of a Medicare Advantage Plan the monthly premium paid for that plan may include the amount for prescription drug coverage.
    • Deductible: $400.25 a year on a national average. Not all plans have a deductible.
    • When enrolling into a Part D plan there is always an option to select a plan that comes with a deductible or not.
    • Within most states, having a Part D plan with a deductible equates in a lower monthly premium.
    • Co-Pays:
    • Set by the insurance company that administers the plan.
    • Co-pays are typically a dollar amount between $1.00 to $50.00 for each prescription filled depending on the type of medication.
    • Co-insurance: 25% to 50%
    • Depending on the medication a plan may charge up to 25% to 50% per prescription.
    • All Co-insurance is set by the insurance company that administers the plan.

    Supplemental Coverage (Medigap):

    Supplemental Coverage covers the gaps within Medicare Parts A and Part B. Plans can extend coverage as well as cover all deductibles and co-pays that are included in Parts A and B.

    • Private insurers administer the plans and they are regulated by the Centers of Medicare Services (CMS).
    • Plans are broken into different types of plans (A – N) and can have varying types of coverage within the plan.
    • Plan F is considered to be the most robust plan, but a healthcare professional can help determine which plan is best suited.
    • Premium: $208.18 a month on a national average.
      • Premiums vary by residency, age and gender as well as the private insurer who administers the plan.
      • This premium is for Medigap Plan F policy which is blended to include non-tobacco and tobacco users.
      • Premiums may be considerably cheaper depending on age, gender, insurer and residency.


    Part C: Medicare Advantage Plans.

    Coverage through a private health insurer who, by law, must provide the exact same coverage that Original Medicare (Parts A & B) provides, but still can offer a wide variety of other types of coverage as well.

    Due to these plans being able to include specific coverage a national average has not been determined.


    Dan McGrath

    Dan McGrath is considered to be a leading authority on the subject of how health related costs in retirement will affect both retirement as well as the overall the financial planning process. Mr. McGrath has also authored the bestselling retirement planning book “What you don’t know about retirement will hurt you” as well as “Medicare: A Practical Guide to Understanding Your Health Coverage in Retirement”. http://www.jesterfinancial.com

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