What Will Medicare Cost in 2013?

Current Articles | RSS Feed RSS Feed

What Will Medicare Cost in 2013?

 

medicare cost for 2013Medicare shares costs with you in four ways:

  • Premium--a fixed fee that you pay each month

  • Deductible--an amount you must pay out-of-pocket before your plan will begin paying some of your costs

  • Copayment (copay)--a fixed amount you pay each time you use a service, fill a prescription or buy a product

  • Coinsurance-- a percentage of the cost for a service or product

Here's a run-down of these costs for Parts A and B in 2013.

What You'll Pay for Part A

Medicare Part A is hospital insurance. Coverage generally includes:

  • A semi-private room

  • Meals

  • General nursing care

  • Drugs

  • Other hospital services and supplies

Part A is premium free for most people. You will pay a premium only if you or your spouse did not work and pay taxes for at least ten years. The 2013 Part A premium is $441 per month.

Part A charges a deductible for each benefit period. A benefit period begins the day you go into a hospital or skilled nursing facility. It ends when you have been out for 60 days in a row. You may have more than one hospital stay during a benefit period. Medicare does not limit the number of benefit periods that it will cover. The 2013 Part A deductible is $1,184 per benefit period.

In addition, you are responsible for some copayments and coinsurance for inpatient stays. The table below shows your portion of the costs.

Covered Inpatient Care

Your Cost

Hospital days 1-60

$0 (after deductible)

Hospital days 61-90

$296 per day

Hospital days 91+

(“lifetime reserve” days)

$592 per day (maximum of 60)

Skilled nursing facility days 1-20

$0 (after deductible)

Skilled nursing facility days 21-100

$148 per day

Skilled nursing facility days 101+

100% of costs


It’s important to know that you must be admitted to the hospital by doctor’s order. If you are there only for observation, Part A will not cover the cost. Always ask whether you have been admitted as an inpatient. In addition, you must be in the hospital as an inpatient for at least three days to qualify for follow-up care in a skilled nursing facility. The day of your discharge does not count.

Some other Part A covered services and your related costs include:

  • Mental health services in the hospital: 20% of Medicare-approved amount

  • Home health care: $0 (after deductible)

  • Durable medical equipment used at home (wheel chairs, walkers, etc.): 20% of Medicare-approved amount

  • Hospice care: $0 (no deductible)

  • Outpatient prescriptions for pain and symptom management during hospice: $5 per prescription

  • Caregiver respite care during hospice: 5% of Medicare-approved amount

Finally, Part A does not cover doctor services in the hospital--Part B does.

What You’ll Pay for Part B

Medicare Part B is medical insurance. It covers doctor visits and outpatient care.

You must pay a premium for Part B. Find your tax filing status and your income to see what you’ll pay in 2013. 

If you file an individual tax return and your income is:

If you file a joint tax return and your income is:

Your Part B premium is:

$85,000 or less

$170,000 or less

$104.90 per month

$85,001 to $107,000

$170,001 to $214,000

$146.90 per month

$107,001 to $160,000

$214,001 to $320,000

$209.80 per month

$160,001 to $214,000

$320,001 to $428,000

$272.70 per month

Over $214,000

Over $428,000

$335.70 per month


In addition to the monthly premium, your Part B costs include an annual deductible of $147. You are also responsible for some copayments and coinsurance, including:

  • 20% of the Medicare-approved amount for doctor services, outpatient therapy and durable medical equipment

  • 20% of the Medicare-approved amount for most doctor services you receive while in the hospital

  • $0 for Medicare-approved clinical laboratory services (after deductible)

  • $0 for home health care services (after deductible)

  • 20% of the Medicare-approved amount for doctor visits to diagnose a mental health condition and to monitor or change prescriptions

  • 35% of the Medicare-approved amount for outpatient mental health treatment

There may be additional costs that Part B may help with. You can contact your State Health Insurance Assistance Program for answers to your questions.

Help Paying for What's Not Covered

Out-of-pocket costs for a serious illness can mount up quickly.

You can add a Medicare supplement insurance plan (Medigap) to Original Medicare to help pay some out-of-pocket costs. Many beneficiaries choose to add a prescription drug plan (Part D) as well. Original Medicare does not include prescription drug coverage.

You may want to look into Medicare Advantage plans (Part C) in your area. These plans combine the coverage of Part A and Part B. Most also include prescription drugs (Part D) and extra benefits like vision, dental and hearing care--all in one plan.

You can get Medicare Advantage, Medicare supplement and prescription drug plans from private insurance companies. Costs vary, depending on the specific plan. Use the Plan Finder at Medicare.gov to see what’s available where you live.

For more information, contact the Medicare helpline 24 hours a day, seven days a week at 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048. If you have questions about Medicare Made Clear, call 1-877-619-5582, TTY 711, 8 a.m. - 8 p.m. local time, seven days a week.

Resources

Medicare.gov: Visit the official U.S. government site for Medicare.

 

Y0066_121217_114203 CMS Accepted