Medicare Costs

Medicare Costs

Understanding your Medicare coverage costs is an important part of the coverage selection and enrollment process.  By knowing what your costs will be BEFORE you enroll in a plan, you can avoid receiving unpleasant bills in the mail that you weren’t expecting.

Your Medicare costs will vary depending on where you live, your income, the specific plan you select and the out-of-pocket expenses relating to your plan.  Additionally, you could qualify for programs that will provide financial assistance and offset some or all of these expenses.  If you think you are eligible for financial assistance, contact your local Medicaid office to gather more information.

The associated Medicare coverage costs you might have to pay include:

Premiums – The set amount that you are required to pay out-of-pocket monthly, whether through your checking account or Social Security check, for Medicare Part B, Medicare Advantage (Part C), your Medicare Part D prescription drug plan and/or your Medicare Supplement plan.

Deductibles – The set amount that you are required to pay out-of-pocket for covered services before your insurance plan begins to provide benefits. 

Coinsurance/Copayments – The portion of the medical services or prescription drugs that you are responsible to pay. Copayments are fixed dollar amounts;  in comparison, coinsurance is calculated as a percentage.

** WATCH: Medicare Costs Video **

Medicare Income Related Monthly Adjustment Amount (IRMAA) for Parts B and D

Medicare has implemented a policy where your Part B and Part D premium can be increased based on your modified, adjusted household gross income (MAGI) on your tax return from two years prior. This increase is called Income Related Monthly Adjustment Amount (IRMAA).

Simply put, this is a surcharge that you might have to pay if your income exceeds certain thresholds. So if your modified, adjusted gross income is greater than the thresholds, you will be responsible for a larger portion of the Part B cost.

This increase in payment is in addition to the purchase of a Medicare supplement or Medicare Advantage plan.

To better understand how your income can impact your Part B and Part D premiums, download our IRMAA Overview below.

Want to learn more about IRMAA?
Download our IRMAA Overview today.

How Can I Keep My Medicare Costs Down?

There are a number of additional tips we can give you to help keep your Medicare costs down.

Make sure that your healthcare providers accept assignment.

Accept Assignment simply means that your doctor, provider or medical supplier contractually agrees to accept the Medicare approved payment as payment in full for the services rendered.

Therefore, your 20% coinsurance would be the only payment that you’re responsible for.

Most providers accept assignment, but you want to make sure before agreeing to services, as those that don’t accept assignment can charge you up to 15% more than the Medicare-approved amount.

Under assignment, the provider agrees to submit your claims and will ask you for payment only after Medicare has processed the claim. Additionally, your out-of-pocket costs could be less.

Make sure that your healthcare provider has not opted out of the Medicare program.

Providers have the choice to not accept Medicare payments for services, which means they can charge you any amount and won’t bill Medicare.

In this case, you’d be responsible for the full cost of services as Medicare won’t pay for the services of a non-participating provider.

It’s important that you verify this prior to receiving care or services. If your provider has “opted out” of Medicare, they are required to inform you prior to providing the service, and they’ll ask you to sign a contract agreeing to pay the full cost of the service.

Need Help with Medicare?


Our knowledgeable insurance agents work with and help you navigate and enroll in the right Medicare through our in-person Medicare consultative services. We offer Medicare education in person, online and over the phone, and best of all, our services are 100% FREE.

Call 703-214-4600 to schedule a phone, online or in-person Medicare consultation today!

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