ABA Family Legal Guide

The Rights of Older Americans

Health and Long-Term Care Benefits

Medicare

What does Medicare cost me?

Part A coverage is provided free to all individuals 65 and older who are eligible for Social Security (even if they are still working). If you are not eligible for Social Security, you can enroll in Part A after age 65, but you will have to pay a sizable monthly premium.

Part B is available to all Part A enrollees for a monthly premium that changes yearly. The Social Security Administration can tell you the cost of the current premium. Under both Parts A and B, beneficiaries must pay certain deductibles and coinsurance payments, fixed annually by the federal government, unless they are enrolled in a managed care organization. Deductibles are payments you must make before Medicare coverage begins. Coinsurance payments are percentages of covered expenses that you are responsible for. Medicare Advantage plans may set different deductibles and co-payments.

Costs for Part C vary depending on a number of factors, including whether the plan pays all or part of the monthly Part B premium; whether the plan charges a monthly premium; whether the plan has a yearly or any additional deductibles; how much you pay for each service; the type of services you need and how often you get them; whether you follow the plan's rules; and the types of extra benefits you need and what it charges for them.

Costs for Part D plans also vary. However, each plan will have a monthly premium, annual deductibles, and co-payments for prescriptions. There are numerous plans available, and you can select the one that best cover's your needs and budget.

Q. I don't have very much money and am afraid that I won't be able to pay the fees. Is there anyway to reduce them?

A. If you meet certain income and resource tests, your state's Medicaid program may assist you in paying Medicare costs. The income and resource tests are more generous than the limits for regular Medicaid eligibility, so even if you are not eligible for Medicaid, you may still be eligible for help.