2012 Original Medicare Costs for Parts A and B

2012 ORIGINAL MEDICARE
Premiums, Deductibles, and Co-Insurance

PREMIUMS

Medicare Part A Premium (Hospital Insurance):

• Most people do not pay a monthly Part A premium because either they or their spouse have 40 or more quarters (10 years) of Medicare-covered employment. For these persons, Medicare Part A is premium-free.
• For people who have only 30-39 quarters (7½ to less than 10 years) of Medicare-covered employment, the Part A premium for 2010 is $254 per month.
• For people who have less than 30 quarters of Medicare-covered employment, the Part A premium for 2012 is $451 per month.

Medicare Part B Premium (Medical Insurance):

• Persons with individual annual income at or below $85,000, or with joint annual income at or below $170,000, pay $99.90/month. Persons with annual income above these amounts will pay more. See Medicare Costs (from Medicare.gov).

Medicare Deductibles and Coinsurance:

Part A Home Health Care:

• Beneficiary pays $0 for home health care services and 20% of Medicare-approved amount for durable medical equipment

Part A Hospice Care:

• $0 for hospice care
• $5 co-payment per prescription for outpatient prescription drugs for pain and symptom management
• 5% of the Medicare-approved amount for inpatient respite care

Part A In-Hospital Stay for Each Benefit Period:

• Beneficiary pays Part A Deductible of $1,156 for each benefit period.
• Beneficiary pays $289 per day for days 61-90 of a hospital stay.
• Beneficiary pays $0 for first 60 days of each benefit period
• Beneficiary pays $578 per ‘Lifetime Reserve Day’ after day 90 of each benefit period (up to a maximum of 60 days over your lifetime).

Part A Skilled Nursing Facility Stay for Each Benefit Period:

• Beneficiary pays nothing for first 20 days.
• Beneficiary pays $144.50 per day for days 21-100.
• Beneficiary pays all costs for each day after day 100 in each beneficiary period

Part B:

• Beneficiary pays annual deductible for 2012 of $140.
• Beneficiary pays 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. (there may be limits on physical therapy, occupational therapy, and speech language pathology services).
• Beneficiary pays 20% for most outpatient hospital services.
• Beneficiary pays 40% for most outpatient mental health care.
• Beneficiary pays nothing for Medicare-approved home health care and clinical laboratory service

Note: There are additional Medicare services that may have cost sharing. For more information, visit the Medicare website or call 1-800-MEDICARE (1-800-633-4227).

This information last reviewed 5/11/12