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Medicare is a government national health insurance program for US citizens aged 65 years and above. The program also covers people younger than 65 but with specific disabilities like ESRD (End-Stage Renal Disease).
Besides hospital admissions stays, healthcare visits, and prescriptions, the Medicare program covers various medical services. The four Parts of Medicare, Part A, B, C, and D, and their costs for 2023 are covered in this article.
Medicare: What is it?
As a social health security need, Medicare was established in 1965 to offer older Americans reliable and convenient health insurance. Since then, the program has included patients with ESRD and people with specific disabilities.
The expansion has seen many people who fall under those categories able to access Medicare insurance services. Medicare program funding is through taxes, premiums, and other contributions from the federal government and other beneficiaries.
Firstly, Part A covers hospitalizations, hospice care, nursing care, and home-based health care—Part B on the other hand, covers doctor visits, outpatient care, and certain preventive care services. As an alternative to Parts A and B, Part C (Medicare Advantage) comes in to help cover health services in both Part A and B, plus other benefits like dental and eye care services. Finally, Part D offers drug prescriptions services.
Medicare Costs in 2023: Here Are the Costs for Each Part of Medicare in 2023
In most cases, many people do not have to pay for Part A Medicare Services because they did so through Medicare tax services while still working. In this case, it could be either they paid Medicare taxes themselves or their spouses paid the taxes for ten years or more. Otherwise, persons who do not enjoy a premium-free Part A can pay a premium of up to $506 monthly.
For hospital admissions, a patient will pay a deductible of $1,600 in a benefit period. In addition, patients will incur coinsurance costs dependent on how long they stay in the hospital. Parents will not incur additional coinsurance costs for their first 60 days of a particular benefit period.
However, they are bound to pay additional coinsurance costs of $400 per day for all days between 60 to 90 days of each benefit period. Additionally, suppose patients extend their hospital stay beyond 90 days, in that case, they will be required to pay $800 per ‘lifetime reserve day’ after the 90th day, up to a maximum of 60 days over their lifetime.
Furthermore, for the skilled nursing facility stay, patients pay $0 for the first 20 days of their benefit period, after which they will pay $200 per day from day 21 to the 100th day of each benefit period. They, however, will be required to meet all costs of their stay beyond the 100 days.
A standard premium amount of $164.90 is the standard amount most healthcare seekers will pay in 2023. However, depending on one’s income, individuals might pay less or more. Social Security will advise patients on the exact amount to bear upon analyzing income and services the beneficiary seeks.
However, one will pay the standard premium ($164.90 per month) only if:
- They are joining the Part B program now for the first time.
- That they do not enjoy Social Security benefits.
- That the beneficiaries are directly billed for their Part B premiums.
- The patients have both Medicare and Medicaid, in which case Medicaid goes first in paying their premiums.
Moreover, beneficiaries will be required to make premium payments of $226 deductible annually that is, they will pay $226 before Original Medicare starts to pay. A 20% Medicare-approved amount will be paid after the annual premium for doctor services, outpatient therapies, and durable medical equipment.
It is also good to note that the amount can be higher, especially if one is late in premium payment, forcing one to pay a late enrollment penalty. The Part B Medicare program has included vaccinations for COVID-19 and some cancer tests like mammograms and colonoscopies.
Part C (Medicare Advantage)
Though the average cost of Medicare Advantage premiums payments was $19 per month, the plan’s cost can change and range from a monthly premium of 0$ to beyond $200. Also, some will need to pay for deductibles and coinsurance services.
Private insurance service providers offer Part C premiums and are highly dependent on what services or plan a patient chooses. It can also vary depending on which state you live. Medicare Advantage has an out-of-pocket spending limit.
Notably, Medicare Advantage Plans offer services related to dental problems, vision, and hearing care not covered by the Original Medicare (Part A and B). In addition to services covered by Original Medicare, private insurance providers offer extra benefits under the Medicare Advantage plan.
It is crucial to seek a professional advice from licensed Medicare agent from the website like Clearmatch Medicare when applying for a Medicare Advantage plan.
Persons with the Original Medicare plan can purchase a Part D, which enables them to have an additional method for drug prescription. Patients with Medicare who have subscribed to the Part D plan will pay about $31.5 for drug prescriptions.
The cost may vary depending on the plan chosen and the approved medications. It is essential to understand that if one does not have a Part D plan alongside their Original Medicare, drug prescription costs are entirely out-of-pocket. Late enrollment also results in permanent cost penalties.
Since private businesses offer Part D, patients must check with them before buying the plan. One factor to consider is if the plan covers prescription drugs that an individual wants. Also, knowing the drug levels of various plans, their cost-sharing obligations, and other limitations on the medication offered is essential when deciding to purchase a Part D plan.