What to Know About Medicare Copayments

For many people first enrolling in, and then covering the costs of Medicare, copayments and coinsurance are important cost-sharing factors to be aware of. Here are some important things to know.

Cost-sharing types

Copayments are the principal type of cost-sharing options, with the other two being in the form of coinsurance and deductibles. Copayments are comprised of a set amount which you pay out-of-pocket. For Medicare, copayments pay deductibles annually for Part B, and in each benefit period for Part A.

For coinsurance, it is 20 percent of the cost of care for Part B. But for Part A, coinsurance is often a flat fee amount. When it comes to Medicare Part D Plans, either coinsurance or copays can apply. This is also how a comprehensive Medicare Advantage Plan can help cover other expenses like doctor visits, which would be similar to standard, non-Medicare plans.

“When you have some skin in the game with copays, the premiums and any rate increases are much more favorable,” says Sandra Brown, president and owner of Senior Watchdog in LaSalle.

Medicare Part A

You’ll be expected to pay coinsurance, which operates like a copay, after your deductible is met. This would be for things like hospital stays. The amounts of the payments can vary depending on the length of the hospital stay.

Medicare Part B

Part A and Part B have different ways of how their deductibles work. But as mentioned before, you’ll be responsible for 20 percent of covered services once the deductible is met for Part B. This is before the Medicare-approved amount, which is the maximum that a health care provider can be paid by Medicare.

Copayments/coinsurance are another part of the complex nature of Medicare Plans.

But with Senior Watchdog, you can rest easy knowing you’ll have the guidance you need to help with every detail of finding the best Plan for you – and how to cover it.

For more information or any questions on getting help with Medicare copayments, visit www.seniorwatchdoginc.com or call us at 815-223-9394.

Senior Watchdog

801 2nd Street

LaSalle, IL 61301