Medicare 2013 costs at a glance

• Monthly premium (for people who pay a premium): If you buy Part A, you'll pay up to $441 each month in 2013.  Most people get premium-free Part A.
• Late enrollment penalty: If you don't buy it when you're first eligible, your monthly premium may go up 10%. (You'll have to pay the higher premium for twice the number of years you could have had Part A, but didn't sign up.) Learn more about the Part A late enrollment penalty.

Part A costs if you have Original Medicare

• Home health care
  • $0 for home health care services.
  • 20% of the Medicare-approved amount for durable medical equipment.
• Hospice care
  • $0 for hospice care.
  • You may need to pay a copayment of no more than $5 for each prescription drug and other similar products for pain relief and symptom control.
  • You may need to pay 5% of the Medicare-approved amount for inpatient respite care. Your cost for respite care may range from $5-$12 per day.
  • Your usual Part B deductible and coinsurance for your doctor’s services (if your attending doctor isn't employed by the hospice).
  • Medicare doesn't cover room and board when you get hospice care in your home or another facility where you live (like a nursing home).
  • If you pay out-of-pocket for an item or service your doctor ordered, but the hospice refuses to give you, you can file a claim with Medicare. If your claim is denied, you may file an appeal.
• Hospital inpatient stay
  • Days 1–60: $1,184 deductible for each benefit period in 2013.
  • Days 61–90: $296 coinsurance per day of each benefit period in 2013.
  • Days 91 and beyond: $592 coinsurance per each "lifetime reserve day" after day 90 for each benefit period (up to 60 days over your lifetime) in 2013.
  • Beyond lifetime reserve days: all costs.

  Note

  You pay for private-duty nursing, a television, or a phone in your room. You pay for a private room unless it's medically necessary.

• Mental health inpatient stay
  • Days 1–60: $1,184 deductible for each benefit period in 2013.
  • Days 61–90: $296 coinsurance per day of each benefit period in 2013.
  • Days 91 and beyond: $592 coinsurance per each "lifetime reserve day" after day 90 for each benefit period (up to 60 days over your lifetime) in 2013.
  • Beyond lifetime reserve days: all costs.
  • 20% of the Medicare-approved amount for mental health services you get from doctors and other providers while you're a hospital inpatient.

  Note

  There's no limit to the number of benefit periods you can have when you get mental health care in a general hospital. You can also have multiple benefit periods when you get care in a psychiatric hospital. Remember, there's a lifetime limit of 190 days.

• Skilled nursing facility stay
  • Days 1–20: $0 for each benefit period in 2013.
  • Days 21–100: $148 coinsurance per day of each benefit period in 2013.
  • Days 101 and beyond: all costs.

• Monthly premium: Most people pay the Part B premium of $104.90 each month in 2013. However, if your modified adjusted gross income as reported on your IRS tax return from 2 years ago is above a certain amount, you may pay more.

   

  If your yearly income in 2011 was		You pay (in 2013)
  File individual tax return	File joint tax return
  $85,000 or less	$170,000 or less	$104.90
  above $85,000 up to $107,000	above $170,000 up to $214,000	$146.90
  above $107,000 up to $160,000	above $214,000 up to $320,000	$209.80
  above $160,000 up to $214,000	above $320,000 up to $428,000	$272.70
  above $214,000	above $428,000	$335.70

   Get more information about your Part B premium from Social Security.
• Late enrollment penalty: If you don't sign up for Part B when you're first eligible or if you drop Part B and then get it later, you may have to pay a late enrollment penalty for as long as you have Medicare. Your monthly premium for Part B may go up 10% for each full 12-month period that you could have had Part B, but didn't sign up for it. Learn more about the Part B late enrollment penalty.

Part B costs if you have Original Medicare

• Part B annual deductible: You pay $147 per year for your Part B deductible in 2013.
• Clinical laboratory services: You pay $0 for Medicare-approved services.
• Home health services:
  • $0 for home health care services.
  • 20% of the Medicare-approved amount for durable medical equipment.
• Medical and other services: You pay 20% of the Medicare-approved amount for most doctor services (including most doctor services while you're a hospital inpatient), outpatient therapy, and durable medical equipment.

• Outpatient mental health services
  • 20% of the Medicare-approved amount for visits to a doctor or other health care provider to diagnose your condition or to monitor or change your prescriptions. The Part B deductible applies.
  • If you get treatment in a hospital outpatient clinic or hospital outpatient department, you may have to pay an additional copayment or coinsurance amount of the hospital. This amount will vary depending on the service provided, but will be between 20-40% of the Medicare-approved amount.
  • 35% of the Medicare-approved amount for outpatient treatment of your condition (like individual or group psychotherapy) in a doctor or other health provider's office or hospital outpatient department.
• Partial hospitalization mental health services: You pay a percentage of the Medicare-approved amount for each service you get from a doctor or certain other mental health qualified professional. You also pay a copayment for each day of partial hospitalization services provided in a hospital outpatient setting or community mental health center, and the Part B deductible applies.
• Outpatient hospital services
  • You generally pay 20% of the Medicare-approved amount for the doctor or other health care provider's services, and the Part B deductible applies.
  • For all other services, you also generally pay a copayment for each service you get in an outpatient hospital setting. You may pay more for services you get in a hospital outpatient setting than you would pay for the same care in a doctor's office.
  • For some screenings and preventive services, coinsurance, copayments, and the Part B deductible don't apply (so you pay nothing).

• Monthly premium: The Part C monthly premium varies by plan.

• Monthly premium: The Part D monthly premium varies by plan (higher-income consumers may pay more). 

• Late enrollment penalty: If you don't sign up for Part D when you're first eligible or if you drop Part D and then get it later, you may have to pay a late enrollment penalty for as long as you have Part D. The cost of the late enrollment penalty depends on how long you went without creditable prescription drug coverage. Learn more about the Part D late enrollment penalty.