2022 Benefits, Premiums and Costs
Medicare Parts A, B, C & D
Medicare Premiums Beneficiary Pays for Part A Monthly Premium
Most people do not pay a monthly Part A premium because they or a spouse has 40 or more quarters of Medicare-covered employment.
- $499/month for those with fewer than 30 quarters of Medicare-covered employment
- $274/month for those with 30-39 quarters of Medicare-covered employment
Beneficiary Pays for Skilled Nursing Facility Stay
- $0 for the first 20 days of each benefit period
- $194.50 per day for days 21–100 of each benefit period
- All costs for each day after day 100 of the benefit period
Beneficiary Pays for Hospital Stay
- $1,556 deductible per benefit period
- $0 for the first 60 days of each benefit period
- $389 per day for days 61–90 of each benefit period
- $778 per “lifetime reserve day” after day 90 of each benefit period (up to a maximum of 60 days over your lifetime)
For 2022 Medicare Part D Costs, most drug plans charge a monthly fee that varies by plan. You pay this in addition to the Part B premium. If you’re in a Medicare Advantage Plan (Part C) or Medicare Cost Plan with drug coverage, the monthly premium may include an amount for drug coverage.If your income was more than $88,000 ($176,000 filing joint) you’ll pay $12.30 + your plan premium
- If your income was more than $91,000 ($182,000 filing joint) you’ll pay $12.40 + your plan premium
- If your income was more than $114,000 ($228,000 filing joint) you’ll pay $32.10 + your plan premium
- If your income was more than $142,000 ($284,000 filing joint) you’ll pay $51.70 + your plan premium
- If your income was more than $170,000 ($340,000 filing joint) you’ll pay $71.30 + your plan premium
- If your income was more than $500,000 ($750,000 filing joint) you’ll pay $77.90 + your plan premium
Deductibles vary between Medicare drug plans. Some Medicare drug plans don’t have a deductible.
- No Medicare drug plan may have a deductible more than $480 in 2022.
Once your deductible is met, you’ll pay a coinsurance (copay) for prescription drugs. Note that the amount of your copay may change during the benefit period, if the drug price fluctuates.
- Initial coverage limit is $4,430 (plan pays 75% – you pay 25%)
- Once you and your plan pay this amount, you’ll continue to pay 25% of the cost of your prescriptions drugs until you reach your threshold
- Annual out-of-pocked threshold is $7,050
Once you and your plan have spent $4,430 on covered drugs in 2022, you’re in the coverage gap (a temporary limit on what the plan covers). Even though you’ll only pay 25% for both brand name and generic drugs at this point, almost the full price of the drug (except for what the plan pays) will count as out-of-pocket costs to help you get out of the coverage gap.
- The manufacturer pays 70% of drug costs
- The plan pays 5% of drug costs
- You pay 25% of drug costs
- The plan also pays 75% of a dispensing fee, you pay 25% of the dispensing fee
Once you reach your threshold ($7,050), you are out of the coverage gap (donut hole) and you’ll automatically get catastrophic coverage. This assures you only pay a small coinsurance amount or copayment for covered drugs for the rest of the year.
- You’ll pay 5% or a small copay (whichever is greater) of the cost of your medications for the rest of the year.
- Your plan pays the rest
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