The Impact of Medicare Costs in Missouri: Understanding Premiums, Deductibles, and Co-pays

Medicare is a critical program for millions of seniors and individuals with disabilities in Missouri, but it’s important to understand the costs associated with it. While Medicare provides essential healthcare coverage, it’s not free. Beneficiaries are responsible for premiums, deductibles, and co-pays. Knowing what these costs are, how they work, and how to manage them can help you make the most of your Medicare coverage.

Medicare Premiums

Premiums are the monthly payments that beneficiaries must pay to have Medicare coverage. There are different premiums for different parts of Medicare:

1. Part A (Hospital Insurance):

   • Most people do not pay a premium for Part A if they or their spouse paid Medicare taxes for at least 10 years. However, for those who don’t meet this requirement, the Part A premium can range from $278 to $506 per month (in 2024).

2. Part B (Medical Insurance):

   • Part B requires a monthly premium. The standard Part B premium in 2024 is $174.70 per month, but it may be higher based on your income. If your income exceeds a certain threshold, you’ll pay an Income-Related Monthly Adjustment Amount (IRMAA) in addition to the standard premium.

3. Part D (Prescription Drug Coverage):

   • Medicare Part D premiums vary depending on the plan you choose. The average monthly premium for a Part D plan in 2024 is approximately $32.74, but it can be higher for plans that offer more coverage. Like Part B, Part D premiums can also be higher for beneficiaries with higher incomes.

4. Medicare Advantage Plans:

   • If you choose a Medicare Advantage plan, your monthly premium can vary depending on the plan you select. Many Medicare Advantage plans have low or no premiums, but you may still be responsible for co-pays, coinsurance, and other out-of-pocket costs.

Medicare Deductibles

A deductible is the amount you pay for services before Medicare starts to pay. Both Part A and Part B have deductibles that must be met before the program covers medical costs.

1. Part A Deductible:

   • The deductible for Part A in 2024 is $1,632 per benefit period. This means that you must pay the first $1,632 of hospital services each time you are admitted to the hospital.

2. Part B Deductible:

   • The Part B deductible in 2024 is $226. Once you meet this deductible, you pay 20% of the Medicare-approved amount for most doctor visits and outpatient services.

Medicare Co-pays and Coinsurance

Co-pays and coinsurance are your share of the costs after your deductible has been met. These vary depending on the services you receive.

• Part A:

  • You may have a daily co-pay for extended hospital stays. For example, in 2024, if you are hospitalized for 61 to 90 days, your co-pay will be $408 per day.

• Part B:

  • After you meet your deductible, you pay 20% of the Medicare-approved amount for most covered outpatient services.

Managing Medicare Costs in Missouri

1. Medigap:

   • Medigap (Medicare Supplement Insurance) can help cover the gaps left by Original Medicare, such as co-pays, coinsurance, and deductibles. Medigap plans are sold by private insurance companies, and the coverage can vary.

2. Medicare Advantage:

   • Some Medicare Advantage plans offer additional coverage, like dental, vision, and hearing care, at an affordable price. These plans may have lower out-of-pocket costs but typically require you to use a network of doctors and healthcare providers.

3. Part D Prescription Drug Plans:

   • For those who need prescription drug coverage, Part D plans can help manage medication costs. Many Part D plans offer coverage for a wide range of drugs, and you can find a plan that fits your needs based on the medications you take.

4. Financial Assistance Programs:

   • There are programs available to help those with limited income and resources, such as Extra Help (Low-Income Subsidy) for prescription drug costs and Medicaid for additional assistance. These programs can help lower the cost of Medicare premiums, deductibles, and co-pays.

Contact Us

At Riverside Insurance Professionals, we’re here to guide you through the Medicare process in Missouri. Our licensed agents are ready to answer your questions and help you select the best plan. If you need assistance, feel free to reach out:

• Phone: (573) 535-6044

• Email: Jennifer@riversideinsuranceprofessionals.com

• Office Hours: Monday – Friday, 9:00 AM to 5:00 PM

For additional official Medicare resources, visit the Medicare Eligibility & Enrollment page on Medicare.gov.