Medicare Basics

Medicare is the US government's health insurance for US citizens over age 65 and those that are disabled under 65 after being on SS disability for 2 years.  US Citizens pay Medicare taxes their working lifetime and qualify for "Free" or $0 premium Part A (hospital services) if they pay into the system for 40 quarters; spouses can qualify through their working spouse.  Medicare Part B (outpatient services), while partially subsidized by taxes, does have a premium.  Premiums vary based on your income at the time you enroll in Medicare, but can be changed if your income goes up or down.

Depending on your income at the time you enroll in Medicare, you can either pay the STANDARD premium for Medicare B or a higher amount, referred to as IRMA - Income Related Monthly Adjustments.  For a list of income levels and premiums, refer to chart in "2023 Medicare B and D premiums" document. The standard Part B premium  is $164.90 for 2023, down $5.20 from the 2022 Part B premium of $170.10.  There is a 2-year ‘look back’ on your income when you first enroll in Medicare. So for 2023 enrollment, the government will look at your 2021 income to calculate your Medicare premiums.  (NOTE:  You could pay more for Medicare Part C or D as well if you your income exceeds certain limits.)

For a list of premiums for B and D based on income, Feel free to download this document:  2023 Medicare B and D premiums  

NOTE:  Video references for IRMA are from 2020; for current numbers, download the 2023 document. 

IMPORTANT NOTE:   If you have a low income or qualify for Medicaid, you should call Social Security at 1-800-772-1213 and ask about EXTRA HELP.  You may qualify for help in paying your Medicare premiums.

Both Medicare A and B are obtained through the Social Security office.  Medicare Part C and Part D are purchased through a broker or can be done by going direct to the insurance company that provides these benefits. 

Medicare Supplements are offered by insurance companies and are NOT a Medicare program, but are additional coverage to help pick up where Medicare leaves off.  

NOTE:  You must be enrolled in both Medicare A and B to enroll in a Supplement and Medicare Part D drug coverage.  If you enroll in a Medicare Advantage Part C plan, you must maintain your enrollment in both Medicare A and Medicare B. 

NOTE:  You cannot be enrolled in Medicare C and Medicare D - you can choose one or the other for your drug coverage. 

              Most people that enroll in a Part D (stand-alone drug card) also purchase a Medicare Supplement to help pay the costs not covered by Medicare, including deductibles for hospitalization, outpatient services, and 20% coinsurance that is not capped.