MEDICARE NEWS

Do all Medicare plans have a deductible?

The Center on Medicare and Medicaid has released the cost of deductibles for Parts A and B of Medicare for members in 2022. All Plans do have a deductible.

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Do all Medicare plans have a deductible?
REUTERS MARCELO DEL POZO

Medicare is divided into four parts, all of which have a deductible and premium, However, Part A and B are mandatory, Part C and D can be purchased to provide increased coverage.

What are the various 'Parts' of Medicare

There are three major 'Parts' of Medicare:

  • Part A: which covers hospital stays, skilled nursing, and hospice services;
  • Part B: which covers outpatient services, most doctors visits, and most drugs that need to be administered by medical professionals; and
  • Part D: which covers most “self-administered” prescriptions.

Some seniors elect to add additional coverage for things like vision and dental through a Part C or Medicare Advantage plan.

Premiums

Premiums are monthly payments paid to receive coverage for healthcare or any other type of insurance.

Part A

In regard to Medicare Part A, ninety-nine percent of Medicare members do not pay a premium for Part A. Those who purchase Part A coverage spent “up to $471 each month in 2021” and will be charged $499 in 2022 “if you paid Medicare taxes for less than 30 quarters” throughout your career.

Part B

However, most do pay one for Part B, which is subtracted from their Social Security checks. In 2021, most paid $148.50, and in 2022 will be charged $171. Those with higher incomes are required to pay more.

Deductibles

Deductibles, which also form part of each Part of Medicare, represent the amount a member must pay before their benefits kick in. Medicare groups co-insurance, or co-payments and deductibles

What is co-insurance?

‘An amount you may be required to pay as your share of the cost for a medical service or supply, like a doctor's visit, hospital outpatient visit, or prescription drug. A copayment is usually a set amount, rather than a percentage. For example, you might pay $10 or $20 for a doctor's visit or prescription drug.’

Source: Medicare.gov

Unlike premiums, the deductible is for Part A is applied to all Medicare members equally.

Part A

For hospital stays, hospice care, skilled nursing facilities, and mental health inpatient stay, will require patients to pay for a certain number of days during their stay to meet the deductible. Then, once the deductible is met, Medicare will cover the remaining costs.

Part A Deductables

Service Deductable
2021 2022
Hospital inpatient stay $1,484 $1,556
Mental health inpatient stay $1,484 $1,556

Source: Medicare.gov

Part B

The deductible for Part B will also increase in 2022. While in 2021, Medicare members had to pay $203, before their benefits kicked in. Next year that figure will increase by 14.7 percent to $233. 

After the deductible is met, those covered will "typically 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 (dme)."

Part C & D: Premiums and Deductibles

Part C, or Medicare Avtange Plans, allows seniors the opportunity to purchase coverage for dental, hearing, and vision services. Some Democrats had proposed expanding Medicare to include these services under the reconciliation bill, but it was stripped after facing opposition from more conservative members of the party and Republicans.

Part D legalized health insurance plans for Medicare members to help keep down the costs of prescription drugs. Medicare.gov provides an estimate of what those who purchase a Part D Plan can expect to pay for their prescription.

The costs associated with these parts depend on the plans selected.

2022 Projected Premiums for Part D

2022 2022 2022 2022

$91,000 or less

$182,000 or less $91,000 or less your plan premium
$91,000 to $114,000 $182,000 to $228,000 N/A $12.40 + your plan premium
$114,000 to $142,000 $228,000 to $284,000 N/A $32.10+ your plan premium
$142,000 to $170,000 $284,000 to $340,000 N/A $51.70 + your plan premium
$170,000 to $500,000 $340,000 to $750,000 $91,000 and less than $409,000 $70.30 + your plan premium
$500,000 and up $750,000 and up $409,000 and above $79.90+ your plan premium

Source: Medicare.gov