Original Medicare is consistent with standardized pricing for covered services and beneficiary costs. You will find variations in costs for Medicare Advantage, Medicare Part D and Medicare Supplement plans across the country due to variations in wages and cost of living.
Original Medicare Covered Services
You will be covered by Medicare for the same services, tests and items in every state and territory across the country.
Original Medicare Costs
One variation you can expect from Medicare across the U.S. is in Medicare Part B costs. Health care providers are allowed to charge up to 15 percent more than the Medicare-approved amount for covered services. This you pay yourself and it’s known as Part B excess charges. You can expect areas with a higher cost of living to charge these prices, especially if you are seeing a specialist or having a procedure performed that requires a high degree of skill.
Medicare Savings Programs
Not all states offer the same Medicare Savings Programs. That is because these are funded by the state government, and the state can choose which programs it offers.
Generally, there are four different savings programs: the Qualified Medicare Beneficiary Program, Specified Low-Income Medicare Beneficiary Program, Qualifying Individual Program, and Qualified Disabled and Working Individuals Program. Income limits are slightly higher in Alaska and Hawaii.
The Qualified Medicare Beneficiary Program has a monthly income limit of $1,094 for individuals and $1,472 for married couples. The resources limit is $7,970 for individuals and $11,960 for married couples. This program helps to pay for Part A premiums, Part B premiums, and deductibles, coinsurance, and copayments for services and items Medicare covers. You pay only small copayments for outpatient prescription drugs.
The Specified Low-Income Medicare Beneficiary Program has an income limit of $1,308 for individuals and $1,762 for married couples. The program has a resource limit of $7,970 for individuals and $11,960 for married couples. This program helps to pay only for Medicare Part B premiums.
The Qualifying Individual Program has an income limit of $1,469 for individuals and $1,980 for married couples. The program’s resources limit is $7,970 for individuals and $11,960 for married couples. The Qualifying Individual Program only helps pay for Medicare Part B premiums.
The Qualified Disabled and Working Individuals Program is for people who have a disability, are working, and lost their disability benefits and premium-free Part A because they returned to work. The monthly income limit for this program is $4,379 for individuals and $5,892 for married couples. The resource limit is $4,000 for individuals and $6,000 for married couples.
Do you have more questions about Medicare? Contact Medicare with Jake for a personalized look at coverage options and costs.
