What You Should Know About Original Medicare Premiums

True or false? Once you turn 65, all Medicare services are free. Many people are surprised to discover: This is false.

While Original Medicare does cover many of the costs of seeing a doctor or going to a hospital, it doesn’t cover everything. And in order to receive benefits, you’ll probably have a Medicare premium, which is - quite simply - a monthly payment.

What Is a Medicare Premium?

The premium is the amount you pay each month to maintain your Medicare coverage. It’s basically the same as an insurance monthly payment, but specific to Medicare. The amounts are standardized for Part A and Part B, as you’ll see below.

You Might Not Have to Pay a Premium for Medicare Part A

Many people over 65 are not required to pay a monthly premium for Part A because they or their spouse paid for it through payroll deductions while they worked. If you or your spouse did not pay enough through Medicare taxes, you may be able to buy Part A coverage.

If you do have to buy Part A and pay for it, the length of time you or your spouse worked and paid into Social Security determines the amount. The amounts for 2017 are:

• $0 per month if time worked is 10 years or more
• $227 per month if time worked is between 7.5 and 10 years
• $413 per month if time worked is fewer than 7.5 years

Almost Everyone Pays a Premium for Medicare Part B

The monthly payment for Part B coverage is based on your income level, as shown on your federal tax return from two years prior. If your income is below $85,000 for an individual or $170,000 for a couple in 2015, your Part B monthly payment will average between $109 and $134 for 2017. If your income is higher, the Part B payment will range from $187.50 to $428.60 per month. You can contact Social Security to learn the exact amount of your monthly Part B payment.

• If you have a Medicare Part D Prescription Drug Plan (PDP), you must pay monthly premiums for it in addition to the Part B premium.
• If you have a Medicare Advantage (Part C) plan that includes prescription drug coverage as well as Parts A and B, your Medicare Advantage monthly premium may already include the Part D premium without you having to pay an additional amount.

Here’s How You Can Pay Your Medicare Part B Premiums

Now that you’ve learned what premiums are, there are a few more things to keep in mind.

• Your Part B premium will be automatically deducted from your benefit payment if you get Social Security, Railroad Retirement Board (RRB), or Office of Personnel Management (OPM) benefits. If you don’t get these benefit payments, you’ll receive a monthly bill.
• If you meet certain income and resource guidelines, you may be able to get help paying for Part A and/or Part B so you can reduce your cost of Medicare. The names of these Medicare savings programs and how they work vary by state; contact your Medicaid office for details.

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A CONSUMER’S GUIDE TO HEALTH INSURANCE FOR PEOPLE ELIGIBLE FOR MEDICARE MAY BE OBTAINED FROM YOUR LOCAL SOCIAL SECURITY OFFICE OR FROM THIS INSURER

Empire BlueCross BlueShield is an HMO plan with a Medicare contract. Enrollment in Empire BlueCross BlueShield depends on contract renewal. Services provided by Empire HealthChoice HMO, Inc. licensee of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans.

Services provided by Empire HealthChoice Assurance, Inc., licensee of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year. You must continue to pay your Medicare Part B premium.

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