BREAKDOWN OF PART A and PART B
and IRMAA
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Here's a breakdown of Medicare Parts A and B, as well as an explanation of IRMAA (Income-Related Monthly Adjustment Amount):
Medicare Part A:
Hospital Insurance:
Medicare Part A primarily covers inpatient hospital care, skilled nursing facility care, hospice care, and some home health care services.
Premiums:
For most people, there's typically no premium for Medicare Part A if they or their spouse paid Medicare taxes while working. If you're not eligible for premium-free Part A, you may be able to purchase it if you meet certain requirements.
Deductibles and Coinsurance:
Part A also includes deductibles and coinsurance. For example, there's a deductible for each benefit period, and coinsurance amounts may apply for extended hospital stays.
OUT-OF-POCKET COSTS
-$0 Monthly Premium
-$1,600 (2024 $1,632) Deductible-60 day window
Hospital Coinsurance
-Days 1-60 $0 Benefit Period
-Days 61-90: $408 /day of each benefit period
-Days 91 and 150: $816 or until lifetime reserve days
have been used (up to 60 days over your lifetime)
Skilled Nursing Stay Coinsurance
-Days 1-20: $0 for each benefit period
-Days 21-100: $204/day for each benefit period
-Days 101 and beyond: All costs
Medicare Part B:
✨ Medical Insurance:
Medicare Part B covers certain doctor's services, outpatient care, medical supplies, and preventive services.
✨ Premiums:
Part B usually requires a monthly premium, which is adjusted annually based on income. Most people pay the standard premium amount set by Medicare, but those with higher incomes may pay more.
✨ Deductibles and Coinsurance:
Part B also includes an annual deductible ($240 for 2024), after which you typically pay 20% of the Medicare-approved amount for covered services.
THERE IS NO CAP!!!!
Income-Related Monthly Adjustment Amount (IRMAA):
IRMAA:
IRMAA is an additional amount that some people with higher incomes must pay for Medicare Part B and Part D (prescription drug coverage). It's assessed based on your modified adjusted gross income (MAGI) from two years ago.
Income Tiers:
The income thresholds for IRMAA change periodically, but generally, if your MAGI exceeds certain thresholds, you'll pay an extra amount on top of your standard Medicare Part B premium.
Notification:
The Social Security Administration notifies individuals if they're subject to IRMAA based on their tax returns from two years prior. You'll receive a letter if you need to pay an IRMAA.
Appeals:
If you experience a life-changing event that affects your income, you can request a new decision regarding IRMAA through a process called a "life-changing event" appeal.
It's essential to understand the costs and coverage associated with Medicare Parts A and B, including any potential additional expenses like IRMAA, to make informed decisions about your healthcare coverage.
