2021 Costs for Original Medicare

With Medicare Part A and Part B, you will pay premiums, deductibles, coinsurance, and copayments for your healthcare. The 2021 deductibles are $1,484 per benefit period for Part A and a yearly $203 for Part B. Part B premiums start at $148.50 in 2021. You can expect to pay 20% of the Medicare-approved amount for covered services as coinsurance.

Part A premiums

Most people receive Medicare Part A without having to pay premiums. These people include:

  • People who or whose spouse worked and paid Medicare payroll taxes for at least 40 calendar quarters
  • People who already receive retirement benefits from Social Security or the Railroad Retirement Board at age 65
  • People who are eligible for retirement benefits but haven’t claimed them yet
  • People who or whose spouse worked in Medicare-covered government employment
  • People under 65 who have been receiving Social Security or Railroad Retirement Board disability benefits for 24 months
  • People under 65 who have End-Stage Renal Disease and:
    • Worked for at least 40 calendar quarters while paying Medicare payroll taxes or were a government employee,
    • Are already eligible for benefits from Social Security or the Railroad Retirement Board, or
    • Are the spouse or child of someone who meets one of the first two requirements

If you have to pay Part A premiums, you will pay one of two prices. People who or whose spouse worked between 30 and 39 calendar quarters while paying Medicare taxes will owe $259 each month in 2021 for Part A. People who or whose spouse worked fewer than 30 calendar quarters while paying Medicare payroll taxes will owe $471 each month for Part A.

Part A deductible

The Part A deductible applies for each benefit period within a single year. A benefit period begins when you are admitted in a hospital or skilled nursing facility and ends 60 days after you last receive inpatient care. The Part A deductible for 2021 is $1,484 for each benefit period.

Part A coinsurance

For Medicare Part A, you pay daily coinsurance after a certain number of days of each benefit period have passed while you are an inpatient in a hospital, as a mental health inpatient, or in a skilled nursing facility.

As a hospital inpatient, you pay no coinsurance for the first 60 days. Day 61-90, you will owe a daily coinsurance of $371 in 2021. Beyond day 90, you will pay $742 each day for up to 60 lifetime reserve days. After you run out of lifetime reserve days, you will owe all costs remaining for that benefit period.

As a mental health inpatient, the daily coinsurance costs are the same as a hospital inpatient. You will also pay 20% of the Medicare-approved amount for mental health services you get from doctors while you are an inpatient.

As a skilled nursing facility inpatient, you owe nothing for the first 20 days of each benefit period. Days 21-100, you owe a daily coinsurance of $185.50. Beyond day 100, you owe all costs for that benefit period.

Part B premiums

The standard Part B premium in 2021 is $148.50. If you made more than $88,000 as an individual in 2019 or more than $176,000 as a married couple in 2019, you will pay higher premiums thanks to an additional charge called the Income Related Monthly Adjustment Amount (IRMAA).

Part B deductible

Medicare Part B has a yearly deductible of $203 for 2021.

Part B copayments/coinsurance

You will pay a copayment for Part B-covered outpatient hospital services, but this is capped at 20% of the Medicare-approved amount for covered services. You will pay a copayment for each service provided. Some preventive services do not require a copayment.

For partial hospitalization mental health services, you will owe a daily coinsurance. Expect to pay 20% of the Medicare-approved amount for home health services, outpatient therapy, durable medical equipment, and outpatient hospital services.

To learn more about Original Medicare and the costs and coverage associated with it, reach out to us today. There is no one else in the great state of Texas that knows insurance like we do.