How Much is Medicare Coinsurance in 2021

How Much is Medicare Coinsurance in 2021? 

Every year Medicare makes cost adjustments to some parts of its health care coverage and beneficiaries may have to pay higher amounts for cost-sharing or coinsurance, Parts A and B premiums, and/or deductibles. These changes take effect on January 1 of each year. 

In most cases, these increases aren’t a lot of money, but they can add up, especially for people living on a fixed income. If you’re looking over your monthly budget and wondering what you’ll be paying for your Medicare coinsurance in 2021, this article has information that can help you figure out how much more you’ll be spending this year for health care insurance.

What are the Medicare Part A coinsurance charges for 2021?

If you have health care coverage with Original Medicare Part A and/or Part B, these benefits pay a share of your medical costs. Your Medicare coinsurance is the amount you pay as your share of your medical costs after you’ve met your deductibles. You can pay for these costs out-of-pocket or through a Medicare Supplement plan, also known as Medigap. 

As of January 1, 2021, your Medicare Part A coinsurance costs if you are admitted to a hospital as an inpatient are: 

• $0.00 coinsurance for days 1 to 60
• $371.00 per day for days 61 through 90
• $742.00 per day for days 91 and after

As of January 1, 2021, your Medicare Part A coinsurance costs if you are admitted to a skilled nursing care facility are:

• $0.00 coinsurance for days 1 to 20
• $185.50 per day for days 21 to 100
• All costs per day for days 101 and after

What are the Medicare Part B coinsurance charges for 2021?

If you have Part B Medicare benefits, Medicare pays for 80 percent of the Medicare-approved, final amount for most of your outpatient services and durable medical equipment and supplies after you have met your deductible. As of January 1, 2021, the Part B deductible is $203.00. You are responsible for the remaining 20 percent of your final, approved charges for services and supplies. 

Here’s an example of how this works: you visit a health care provider for the first time in 2021 for a Medicare-covered service and your provider bills Medicare for $300.00. You pay your Original Medicare Part B deductible of $203.00 out-of-pocket because this is your first health care visit of the year. Then, Medicare pays 80 percent of the remaining cost, which is $97.00, and you pay 20 percent which is $19.40. In other words, your first health care visit costs a total of $222.40. 

Do Medigap plans help pay coinsurances?

If you have a Medicare Supplement, or Medigap, plan, you might have coverage for some coinsurance costs. There are 10 Medigap plans – A, B, C, D, F, G, K, L, M, and N – and each one has different coverage as listed below:

1. All 10 plans cover 100 percent of Medicare Part A coinsurance and hospital costs and up to an additional 365 days of care after your Medicare benefits end.

2. Medigap plans A and B cover 100 percent of Medicare Part A hospice coinsurance and your Part B coinsurance. 

3. Plans C, D, F, G, M, and N also cover 100 percent of Medicare Part A hospice coinsurance as well as the Part B coinsurances, and the coinsurance for skilled nursing facility care. 

4. Plan K also covers 50 percent of Medicare Part A hospice coinsurance, 50 percent of coinsurance costs under Part B, and 100 percent of your coinsurance for skilled nursing care. 

5. Plan L also covers 75 percent of Part A hospice coinsurance, 75 percent of Part B coinsurance, and 100 percent of skilled nursing care coinsurance.

Although Plan C and Plan F are no longer sold to new enrollees, if you had purchased a plan prior to January 1, 2020, you can likely keep you coverage. 

 

How Medicare Advantage may help

 

Original Medicare coinsurance can add up and there are no limits to your out-of-pocket expenses each year. Medicare Advantage plans are an alternative to Original Medicare. MA plans will include the same Part A and Part B benefits as Original Medicare, but most plans include additional coverage. Many MA plans provide annual out-of-pocket maximum limits, which can protect you from unexpected coinsurance amounts.