Premium:  40 work quarters = $0

Less than 30 quarters = $565.00

30-39 quarters = $311.00

Key:

• Shaded areas—Medicare Pays
• White areas—You Pay

Premium: $202.90

Unless individual income is over $109,000

or couple $218,000

Part A

Each benefit period*

In-patient hospital

• First 60 days → $1,736.00 Deductible
• Days 61-90 → $434.00 per day
• Lifetime Reserve Days 91-150 → $868.00 per day

Blood

• First 3 pints

Skilled Nursing Facility

• First 20 days → 100% (No co-pay)
• Days 21–100 → $217.00 per day

Home Health Hospice : 100%

• $5.00 prescription drug co-pay
• 5% co-insurance
• Inpatient respite care

* Benefit period ends when patient is out of the hospital or skilled nursing facility for 60 consecutive days.

Part B

$283.00 Deductible

(per calendar year – January 1-December 31)

80%

• Physician’s Charges
• Durable Medical Equipment & Supplies
• Ambulance
• Outpatient Hospital
• Lab Services

20%

• Coinsurance

Blood 

First 3 pints

Preventive Services at 100%

Welcome to Medicare Exam, screenings for:abdominal aortic aneurysm, alcohol misuse, bone mass measurements, breast cancer, cardiovascular disease, cervical & vaginal cancer, colorectal cancer, depression, diabetes, hepatitis C, HIV, lung cancer, obesity

Also includes: PSA, Flu, pneumococcal, hepatitis B shots, Yearly Wellness

With Co-pay or deductible:
glaucoma test, prostate cancer-digital rectal, barium enema, diabetes self-management