Medicare 2016 & 2017 costs at a glance

• Monthly premium (for people who pay a premium):

  If you buy Part A, you'll pay up to $411 each month in 2016 ($413 in 2017).

  Most people get premium-free Part A. Calculate my premium.

• Late enrollment penalty: 

  • If you don't buy it when you're first eligible, your monthly premium may go up 10%. (You'll have to pay the higher premium for twice the number of years you could have had Part A, but didn't sign up.) Learn more about the Part A late enrollment penalty.

Part A costs if you have Original Medicare

• Home health care

  • $0 for home health care services.
  • 20% of the Medicare-approved amount for durable medical equipment.

• Hospice care

  • $0 for hospice care.
  • You may need to pay a copayment of no more than $5 for each prescription drug and other similar products for pain relief and symptom control while you're at home. In the rare case your drug isn’t covered by the hospice benefit, your hospice provider should contact your Medicare drug plan to see if it's covered under Part D.
  • You may need to pay 5% of the Medicare-approved amount for inpatient respite care.
  • Medicare doesn't cover room and board when you get hospice care in your home or another facility where you live (like a nursing home).

• Hospital inpatient stay

  • $1,288 deductible for each benefit period ($1,316 in 2017).
  • Days 1–60: $0 coinsurance for each benefit period ($0 in 2017).
  • Days 61–90: $322 coinsurance per day of each benefit period ($329 in 2017).
  • Days 91 and beyond: $644 coinsurance per each "lifetime reserve day" after day 90 for each benefit period (up to 60 days over your lifetime) ($658 in 2017).
  • Beyond lifetime reserve days: all costs.

  Note

  You pay for private-duty nursing, a television, or a phone in your room. You pay for a private room unless it's medically necessary.

• Mental health inpatient stay

  • $1,288 deductible for each benefit period ($1,316 in 2017).
  • Days 1–60: $0 coinsurance per day of each benefit period ($0 in 2017).
  • Days 61–90: $322 coinsurance per day of each benefit period ($329 in 2017).
  • Days 91 and beyond: $644 coinsurance per each "lifetime reserve day" after day 90 for each benefit period (up to 60 days over your lifetime) ($658 in 2017)
  • Beyond lifetime reserve days: all costs.
  • 20% of the Medicare-approved amount for mental health services you get from doctors and other providers while you're a hospital inpatient.

  Note

  There's no limit to the number of benefit periods you can have when you get mental health care in a general hospital. You can also have multiple benefit periods when you get care in a psychiatric hospital. Remember, there's a lifetime limit of 190 days.

• Skilled nursing facility stay

  • Days 1–20: $0 for each benefit period ($0 in 2017).
  • Days 21–100: $161 coinsurance per day of each benefit period ($164.50 in 2017).
  • Days 101 and beyond: all costs.

• Late enrollment penalty:

In  most cases, if you don't sign up for Part B when you're first eligible, you'll have to pay a late enrollment penalty for as long as you have Part B. Your monthly premium for Part B may go up 10% for each full 12-month period that you could have had Part B, but didn't sign up for it. Also, you may have to wait until the General Enrollment Period (from January 1 to March 31) to enroll in Part B, and coverage will start July 1 of that year.

Learn more about the Part B late enrollment penalty.

 

Part B costs if you have Original Medicare

• Part B annual deductible:

  You pay $166 per year ($183 in 2017) for your Part B deductible. After your deductible is met, you typically pay 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.

• Clinical laboratory services:

 You pay $0 for Medicare-approved services.

• Home health services:

  • $0 for home health care services.
  • 20% of the Medicare-approved amount for durable medical equipment.

• Medical and other services:

You pay 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.

• Outpatient mental health services:

  • You pay nothing for your yearly depression screening if your doctor or health care provider accepts assignment.
  • 20% of the Medicare-approved amount for visits to a doctor or other health care provider to diagnose or treat your condition. The Part B deductible applies.
  • If you get your services in a hospital outpatient clinic or hospital outpatient department, you may have to pay an additional copayment or coinsurance amount to the hospital.

• Partial hospitalization mental health services:

You pay a percentage of the Medicare-approved amount for each service you get from a doctor or certain other qualified mental health professionals if your health care professional accepts assignment. You also pay coinsurance for each day of partial hospitalization services provided in a hospital outpatient setting or community mental health center, and the Part B deductible applies.

• Outpatient hospital services:

  • You generally pay 20% of the Medicare-approved amount for the doctor or other health care provider's services, and the Part B deductible applies.
  • For all other services, you also generally pay a copayment for each service you get in an outpatient hospital setting. You may pay more for services you get in a hospital outpatient setting than you would pay for the same care in a doctor's office.
  • For some screenings and preventive services, coinsurance, copayments, and the Part B deductible don't apply (so you pay nothing).