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SHINE: Serving the Health Insurance Needs of Everyone

new SHINE logoMedicare Part B premiums, deductibles and coinsurance for 2019

Lorraine York Edberg headshotLorraine York-EdbergThe Centers for Medicare and Medicaid announced the Medicare Part A and B premiums and deductibles for 2019.

These figures are based on the Social Security Cost of Living increase of 2.8% for 2019, which equates to an increase of $28 monthly for every $1,000 you receive in Social Security.

The standard monthly premium for Medicare Part B in 2019 will be $135.50, up from $134 in 2018. Some beneficiaries will pay less than the full standard monthly premium amount due to the statutory hold harmless provision, which limits certain beneficiaries’ increase in their Part B premium to be no greater than the increase in their Social Security benefits.

Medicare beneficiaries whose individual income is above $85,000 annually or a couple’s joint income above $170,000 annually will pay an increased amount for their Part B and Part D, called an income-related monthly adjustment amount, also known as “IRMAA.” The Federal government bases the 2019 adjustments on the beneficiaries’ 2017 Federal Income taxes. You may request a new initial determination through Social Security if you believe your IRMAA is incorrect by contacting your local Social Security office. Some other beneficiaries will be paying higher Part B premiums if they are on Medicare Part B, but not yet collecting their Social Security benefit.

The monthly Part B premium for those who are enrolled helps pay for doctors' services, x-rays and tests, outpatient hospital care, ambulance service, medical supplies, and other medical equipment. 

The 2019 Part B annual deductible will be $185 for all people with Medicare, an increase of $2 from 2018. The Part B deductible is annual; once you have incurred $185 of expenses for Medicare-covered services in any year, the Part B deductible does not apply to any further covered services you receive for the rest of the year.

Medicare Part A (Hospital Insurance) helps pay for hospital care, skilled nursing care, home health care, hospice care, and other services. The Part A deductible will increase from $1,340 to $1,364 for beneficiaries with Medicare only; the Part A deductible is the beneficiary’s only cost for up to 60 days of Medicare-covered inpatient hospital services. The 61st to the 90th day has increased from $335 to $341 a day, and beyond the 90th day has increased from $670 to $682 a day. For beneficiaries who have a Medigap plan to supplement Medicare, often most of these costs are covered by their supplemental insurance.

The skilled nursing facility coinsurance increased from $167.50 to $170.50 for the 21st to the 100th day. Medicare Part A covers the first 20 days in a skilled nursing facility, after a three-day qualifying stay in a hospital.

Many Medicare beneficiaries purchase additional insurance to cover the gaps of Medicare to help reduce out-of-pocket expenses.

This article is based on a news release from the Centers for Medicare and Medicaid Services.

The SHINE Program, Serving the Health Insurance Needs of Everyone… with Medicare, provides free, confidential, and unbiased health insurance counseling for Medicare beneficiaries. To reach a trained and certified counselor in your area, contact the regional office at 1-800-498-4232 or 413-773-5555 or contact your local council on aging.