2019 MEDICARE COST-SHARING
Medicare has released the 2019 Medicare cost-sharing amounts and MOOP for standardized Medicare Supplement Plans. Without further ado, here it is!
Part A: Hospital Insurance
- $1,364 (+$24) deductible per benefit period.
- $341 (+$6) for days 61-90.
- $682 (+$12) for 60 lifetime reserve days (days 91-150.)
- $170.50/day (+$3) for days 21-100.
Part A premium
- $437 if you’ve worked less than 30 quarters.
- $240 if you’ve worked over 30 quarters but less than 40.
Part B: Medical Insurance
- $135.50 premium. Deductible remains at $185.
- Cost-sharing remains the same for Part B services, Medicare pays 80% and the beneficiary pays 20%.
Part D: Prescriptions
- The standard part D deductible for 201 is $415. Many plans however have eliminated the deductible entirely.
Initial coverage limit: $0 – $3,820
- After the deductible has been met, beneficiaries enter into stage 2, the Initial Coverage Limit. At which point beneficiaries will either pay 25% or more typically they will have co-pays for tiers 1 – 5.
- Once the retail amount (what you pay + what the carrier pays) of your prescriptions reaches $3,820 for the year, beneficiaries will enter into gap also known as the “doughnut hole.”
Coverage Gap/Doughnut hole: $3,820 – $5,100
- Once in stage 3, more commonly referred to as the “Gap” or the “Doughnut-Hole” beneficiaries will be paying 25% for brand name drugs and 37% for generics.
- After out-of-pocket (what you and the manufacturer pay) costs reach $5,100 beneficiaries will enter into stage 4 or “Catastrophic Coverage.”
- Once in stage 4, beneficiaries will pay the greater of:
- 5% OR
- $3.40 copay for generics and $8.50 copay for all other drugs.
Prescription drug coverage premiums range from $12.70 and up.
Part C – Medicare Advantage plans
Premiums for Medicare Advantage plans range from $0 and up.
Cost sharing for Medicare Supplement plans
- Deductible for the High Deductible plan F is $2,300
- Plan K: $5,560
- Plan L: $2,780