No. Even though Medicare can cover many of your health care costs, you’ll still have some out-of-pocket expenses, including premiums, deductibles, copayments and coinsurance.
While original Medicare doesn’t pay for some of the care you need, such as most dental, hearing and vision services, it does offer almost universal coverage to adults 65 and older. Fewer than 1 percent were uninsured in 2021, versus more than half before Medicare started paying benefits in 1966. Yet, for 1 in 5 adults of Medicare age, out-of-pocket health care costs in 2021 exceeded $2,000, according to a survey from the Commonwealth Fund.
Here are the expenses that each part of Medicare covers, and how much of the costs you may need to pay yourself.
What are the costs for Medicare Part A hospitalization?
Premium. Most people don’t pay premiums for Medicare Part A, which covers inpatient stays in hospitals and skilled nursing facilities, some home health services and end-of-life hospice care. You don’t have to pay Part A premiums if you or your spouse had Medicare taxes deducted from your paychecks for at least 40 quarters of work, the equivalent of 10 years or more. The quarters don’t have to be consecutive.
If you don’t qualify for premium-free Part A, you can choose not to buy it. But if you do have to pay, you’ll also need to pay for Part B. Part A premiums in 2023 are:
- $278 a month if you or your spouse paid 30 to 39 quarters of Medicare taxes.
- $506 a month if you or your spouse paid fewer than 30 quarters of Medicare taxes.
Deductible. You must pay a $1,600 Part A deductible for each benefit period you’re hospitalized in 2023. A benefit period begins when you’re admitted to a hospital or skilled nursing facility as an inpatient — that’s an important distinction because so many places also have outpatient centers — and ends when you’ve been out of the hospital or facility for 60 days in a row.
Coinsurance. You may also have to pay a portion of the costs, called coinsurance, if you stay in a hospital or skilled nursing facility for a long time. Medicare covers your first 60 days as a hospital inpatient, but in 2023 you have to pay $400 a day for days 61 to 90 and $800 a day for up to 60 lifetime reserve days.
Each lifetime reserve day can be used only once but can apply to different benefit periods. You have to pay all costs beyond 90 days per benefit period if you use up your lifetime reserve days.
If you have a qualifying stay in a skilled nursing facility, Medicare can cover the first 20 days. But you’ll have to pay coinsurance for days 21 to 100, at $200 a day in 2023, and all costs beyond day 100.
If you’re receiving end-of-life care through a hospice program, you may have to pay up to $5 per prescription for pain and symptom management and 5 percent of the Medicare-approved amount for respite care.