When it comes to Medicare expenses, budgeting is equally as important as managing the costs you pay. Given that Medicare does not cover everything, setting up a budget will help keep you from running into financial troubles. Read our Medicare budget tips to see how you can manage Medicare expenses and medical costs.
Saving For Part A
Medicare Part A covers hospital insurance, hospice care, and limited home health services. Here are the costs to save for:
*Most beneficiaries don’t pay the Part A premium, but you may have to if you or your spouse have not paid Medicare taxes for 10 years.
Deductible: $1,288 per each benefit period
Co-insurance: Costs per benefit period:
Day 1-60: $0
Day 61-90: $322/day
Day 91+: $644/day per lifetime reserve day
Skilled Nursing Facility Co-insurance:
Day 1-20: $0
Day 20-100: $161/day
Approximate Minimum Cost: $1,771
Example: Mr. Roberts is enrolled in Part A. He doesn’t need to pay for the premium, as he’s paid Medicare taxes for over 10 years. He stayed in a hospital for 62 days.
Since it’s $322 per day after day 60 and he stayed 62 days. Plus, the $1,288 cost per benefit period.
Altogether, Mr. Roberts has paid $1,932 for Part A.
Saving For Part B
Medicare Part B covers health care services, doctor office visits, laboratory fees and radiology. Here are the costs to save for:
Premium: Most people in 2017 pay $109/month
Deductible: $183 in 2017
Individual Services & Supplies: 20% of the service after you pay off the deductible
Approximate Minimum Cost: $270.90, not including individual services.
Example: Ms. Allen is enrolled in Part B for the first time in 2016. She paid off her deductible, after which she got a test at the doctor’s.
($109 + $183 = $292) the premium and deductible + (0.2 x $103= 20.6) 20% off of the blood test.
$292 + ($103 – 20.6 = 82.4) = $374.40
Altogether, Ms. Allen has paid $374.40 for Part B.
Saving For Part D
Medicare Part D covers prescription drug costs. Since they are sold by private insurance companies, the costs tend to vary, especially the premiums. Here are the costs to save for:
Premium: $10-$100 range
Prescription Costs: 75% of prescription costs are paid for after you pay off the deductible
Coverage Gap (Donut Hole): You pay 45% on name-brand drugs and 58% for generic drugs.
Approximate Minimum Cost: $460
Ms. Wells has Medicare Part D. She buys generic prescription drugs. Her latest medicine costs $40 before Medicare coverage. Her premium is $20.
($20+ $360= $380) Premium and deductible +
(0.75x $40=$30) How much Part D pays, Ms. Wells has $10 left to pay.
$380 +10= $390
Altogether, Ms. Wells has paid $390 for Part D.
It is easy to get a firm grip on your Medicare budget when you avoid any penalties. Beneficiaries incur penalties when they sign up late to Medicare parts. Make sure you sign up for Medicare on time if you are new to this insurance.
If you sign up late, you will be subject to the following penalties:
|Penalty||Medicare Part||Reasons for Costs|
|10% increase in premiums
|Part B||For every 12-month delay|
|1% of the national base beneficiary premium ($34.10 in 2016, $35.63 in 2017) x the # of months you didn’t have Part D||Part D||For 63+ consecutive days with no coverage after qualifying for Medicare|
Budgeting For What Medicare Doesn’t Cover
Budgeting for Medicare requires more than merely mapping out the charges for each type of coverage offered. It is vital to also take into consideration the services Medicare does not cover. You may need services and supplies beyond the Medicare coverage umbrella. Below is a list of important services you will have to pay out-of-pocket, as Medicare doesn’t cover them.
Routine Dental and Vision Care:
• Dental cleanings, checkups, fillings & dentures
• Eye refractions, eye exams, contact lenses, eyeglasses (unless it’s after a cataract surgery)
• Acupuncture, chiropractic care (except to cure subluxation of the spine) & other types of alternative care
• Adult day care, assisted living facilities, nursing home
• Help with dressing, bathing and toileting, housekeeping services
• Routine hearing exams, hearing aids (hearing implants to treat hearing loss may be covered)
• Corn and callus removal, orthopedic shoes, foot supports
• X-ray copies, nonemergency transportation, i.e. ambulettes
How Medigap Can Help
If you have difficulty paying off Medicare costs, look into enrolling in Medigap. Also called Medicare Supplement, Medigap relieves you of paying major costs like co-insurance, copayments, and deductibles.
It is sold by private companies with the purpose of helping beneficiaries pay for what Original Medicare does not cover. Medigap doesn’t offer new benefits, rather it supplements your Original Medicare out-of-pocket costs.
The Need To Budget
The ability to afford and manage Medicare expenses begins with compiling a budget for the costs you will pay. Besides paying for Medicare services, you may have to pay for the various services Medicare does not cover.
Consider what you and your spouse require to meet proper healthcare services. Once you lay out a concrete number towards the Medicare parts, you can start to aggregate the costs for additional services Medicare does not cover.