A) I’m glad you asked about PA Medicare and the premium costs. Medicare is a federal health insurance program for people who are 65 or older, disabled, or have certain chronic conditions. Medicare has different parts that cover different types of services. Part A covers inpatient hospital care, skilled nursing facility care, hospice care, and some home health care. Part B covers doctor visits, outpatient services, preventive care, and some home health care. Part C, also known as Medicare Advantage, is an alternative way to get your Medicare coverage through a private insurance company that contracts with Medicare. Part D covers prescription drugs.
The premium costs for Medicare depend on several factors, such as which parts you have, your income level, and whether you qualify for any cost-saving programs. Here are some general information about the premium costs for each part of Medicare in Pennsylvania in 2023:
- Part A: Most people don’t have to pay a premium for Part A because they paid Medicare taxes while working. If you don’t qualify for premium-free Part A, you might be able to buy it. In 2023, the premium is either $278 or $506 each month, depending on how long you or your spouse worked and paid Medicare taxes. You also have to pay a deductible of $1,600 for each time you’re admitted to the hospital per benefit period, and some copayments for longer stays.
- Part B: The standard premium for Part B is $164.90 each month in 2023. However, you might pay more or less depending on your income and whether you get Social Security benefits. You also have to pay an annual deductible of $233 in 2023, and 20% coinsurance for most services after you meet the deductible1.
- Part C: The premium for Part C varies depending on the plan you choose and the area you live in. The average premium for a Medicare Advantage plan with prescription drug coverage in Pennsylvania is $19.20 per month in 2023, and you may be able to find plans in your area of Pennsylvania that have $0 premiums. You also have to pay any deductibles, copayments, or coinsurance that your plan requires. The average medical deductible for a Pennsylvania plan in 2023 is $0 per month.
- Part D: The premium for Part D also varies depending on the plan you choose and your income level. The national average premium for a Part D plan in 2023 is $33.06 per month. However, you might pay more if you have a higher income or if you didn’t enroll in Part D when you were first eligible. You also have to pay any deductibles, copayments, or coinsurance that your plan requires.
If you need help paying for your Medicare costs, you may be eligible for some cost-saving programs in Pennsylvania. These include:
- Extra Help: This program helps pay for prescription costs, premiums, deductibles, and coinsurance of Medicare prescription drug coverage for qualified beneficiaries. It is also known as the Part D Low-Income Subsidy (LIS).
- Medicare Savings Program (MSP): This program helps pay for Medicare premiums. In some cases, it may also pay Medicare Part A and Part B deductibles, coinsurance, and copayments if you meet certain conditions. It is also known as the Medicare Buy-In Program.
- Medicare Supplement Insurance (Medigap): This is a type of private insurance that helps pay some of the health care costs that Original Medicare doesn’t cover, such as deductibles, coinsurance, and copayments. Medigap plans are standardized and regulated by the state and federal government. On average, a Medigap plan in PA ranges between $50-$300 per month, but this depends on things such as your plan letter and many other factors.
To find out more about these programs and how to apply for them, you can contact a PA MEDI Counselor by calling your local Area Agency on Aging (AAA) using the AAA Locator, or by calling the PA MEDI Helpline at 1-800-783-7067 from 8 a.m. to 5 p.m. Monday-Friday. A PA MEDI Counselor can help you determine your eligibility and provide you with objective and easy-to-understand information about your Medicare options.
I hope this information was helpful to you. If you have any other questions about PA Medicare and the premium costs, please feel free to ask me.