Medicare Part B Costs in 2019

Part B is what covers the bulk of your healthcare expenses. Understand how much you will pay out of pocket and budget for the year ahead.

The annual deductible for Part B is $185 in 2019, a $2 increase from 2018. You are required to pay the full deductible amount before Medicare will start paying towards your health expenses.

You pay monthly premiums for Medicare. If you do not pay your premiums in a timely manner, your coverage will be taken away. You are given a 90-day grace period to make payments before your Part B coverage is canceled.

In 2018, Part B premium rates stayed at 2017 rates across five income brackets. What changed were the income brackets themselves. Many people were surprised to find out they were paying considerably more for the same income. Price hikes hit people in the top three income brackets.

In 2019, not only do your premium rates increase across all income brackets but the brackets change again. Instead of five income brackets, there are now six. The change in brackets affects those at the highest income level only. 

* Note that income brackets are based on your last completed income tax return. For 2019, please refer to your 2017 filing.

A sixth income bracket is formed by dividing the highest 2018 income bracket in two. Individuals earning more than $500,000 are most affected.

A sixth income bracket is formed by dividing the highest 2018 income bracket in two. Married couples earning more than $750,000 are most affected.

A third income bracket is formed by dividing the highest 2018 income bracket in two. Individuals earning more than $415,000 are most affected.

Interestingly, someone who earned more than $415,000 but less than $500,000 would pay less on Part B premiums per month than if they were single or divorced. It seems a married individual filing separately has the most at stake.

You cannot be expected to pay more for Medicare if there is not also a rise in Social Security benefits. The holds harmless provision protects Social Security recipients from paying higher premiums if they meet certain criteria.

• You were entitled to Social Security benefits as of November the previous year.
• Your Medicare Part B premiums were directly deducted from your Social Security check from November the previous year to January the current year.
• Any Social Security cost of living adjustment (COLA) increase is not enough to cover the cost of the premium increase.
• You are in the lowest income category.

The Social Security COLA for 2019 is 2.8 percent. Without significant increases in premiums this year, you are expected to pay the listed rate. In years past, when the COLA was not enough to cover the cost of a price increase, beneficiaries who met the above criteria were allowed to pay Part B premiums at the previous year's rate.

For those who are dual eligible, Medicaid will pay their Medicare premiums. They will be charged the higher Part B premium rates.

You can elect to have Original Medicare (Parts A and B) or a Medicare Advantage plan (Part C). Medicare Advantage plans are offered by private insurance companies and will cover everything that Original Medicare offers and more.

Even if you decide on a Medicare Advantage plan and pay premiums to the insurance company, you still have to pay Part B premiums to the government. You must take that added cost into consideration.

The Part B coinsurance remains unchanged. Medicare pays 80 percent and you pay 20 percent with the exception of preventive screening tests. As long as your doctor accepts assignment, your preventive screening tests will be free.

The majority of your healthcare will be paid for by Medicare Part B. Likewise, the majority of your out of pocket expenses will relate to Medicare Part B. Knowing what you are expected to pay for deductibles, premiums, and coinsurance in 2019 will help you to budget appropriately.