Although Medicare pays the lion’s share of the medical costs for its enrollees, prepare to pay some costs yourself. If you have original Medicare, you can get supplemental Medigap coverage and a separate Part D drug plan to help with many of these expenses. Here’s a rundown:
Premium. Each part of Medicare may have its own monthly fee. Most people pay no premium for Part A, which covers hospital services. Whether you choose original Medicare or get a Medicare Advantage plan, you’ll be responsible for the Part B premium, which is $164.90 a month for most people in 2023. If you enroll in a Medicare Advantage plan or a Part D plan, you also may owe a monthly premium, depending on the plan you select.
Deductible. You may have to pay a set amount before Medicare starts paying for your care. The Part A deductible in 2023 is $1,600 per benefit period — not annually — and the Part B deductible is $226 for the year. A benefit period for Part A begins the day you’re admitted as an inpatient to a hospital or skilled nursing facility and extends until you haven’t received inpatient care in either facility for 60 days. This means you can end up with multiple Part A benefit periods in a year, and each triggers another deductible. Many Part D plans also have deductibles.
Copayment. This is a fixed amount you must pay every time you receive a medical service. For example, if you have original Medicare without supplemental coverage, you may have to pay $400 a day if you’re in the hospital for 61 to 90 days during each benefit period in 2023. Part D plans have copays based on the type of drug you need.
Coinsurance. You may have to pay a percentage of the cost of a medical visit or service. If you have original Medicare, you generally have to pay 20 percent of the doctor and outpatient charges covered under Part B. Some of the most expensive drugs in Part D plans also may require you to pay a percentage of the cost.