Part A Monthly Premium (For those not automatically
enrolled)
- 0-29 qualifying quarters of employment: $471
- 30-39 quarters: $259
Inpatient Hospital
- Deductible, Per Spell of Illness: $1,484
- Co-pay, Days 1 – 60: $0
- Co-pay, Days 61 – 90: $371/day
- Co-pay, Lifetime Reserve Days: $742/day
Skilled Nursing Facility
- Co-pay, Days 1 – 20: $0
- Co-pay, Days 21 – 100: $185.50
Standard Monthly Part B Premium
- $148.50
Part B Deductible
- $203
2021 Parts B and D Income-Related
Premiums
|
Beneficiaries who file
an individual tax return with income: |
Beneficiaries who file
a joint tax return with income: |
Beneficiaries who are
married, but file a separate tax return with income: |
2021 |
2021 |
|
Less than or equal to
$88,000 |
Less than or equal to
$176,000 |
Less than or equal to
$88,000 |
$148.50 |
your plan premium |
|
Greater than $88,000
and less than or equal to $111,000 |
Greater than $176,000
and less than or equal to $222,000 |
|
$207.90 |
$12.30 + your plan
premium |
|
Greater than $111,000
and less than or equal to $138,000 |
Greater than $222,000
and less than or equal to $276,000 |
|
$297.00 |
$31.80 + your plan
premium |
|
Greater than $138,000
and less than or equal to $165,000 |
Greater than $276,000
and less than or equal to $330,000 |
|
$386.10 |
$51.20 + your plan
premium |
|
Greater than $165,000
and less than $500,000 |
Greater than $330,000
and less than $750,000 |
Greater than $88,000
and less than $412,000 |
$475.20 |
$70.70 + your plan
premium |
|
Greater than or equal
to $500,000 |
Greater than or equal
to $750,000 |
Greater than or equal
to $412,000 |
$504.90 |
$77.10 + your plan
premium |
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