Appendix C
Medicare Cost Sharing Amounts
This appendix provides cost sharing amounts for Medicare.
Medicare Part A Cost Sharing Amounts
|
Cost Type |
2023 |
2024 |
|
Premium |
Send SVES |
Send SVES |
|
Deductible |
$1,600 |
$1,632 |
|
Hospital Coinsurance days 61-90 |
$400 |
$408 |
|
Hospital Coinsurance days 91-150 |
$800 |
$816 |
|
Skilled Nursing Facility Coinsurance days 1-20 |
$0 |
$0 |
|
Skilled Nursing Facility Coinsurance days 21-100 |
$200 |
$204 |
Medicare Part B Cost Sharing Amounts
|
Cost Type |
2023 |
2024 |
|
All Other Premium Amounts |
Send SVES |
Send SVES |
|
Deductible |
$226 |
$240 |
|
MSHO and SNBC plans that will pay the portion listed of the Medicare Part B Premium |
None |
None |
Medicare Part D Cost Sharing Amounts
For information about which Medicare Part D plans in Minnesota are benchmark plans, refer to the Resources section in ONEsource for the Amounts in Excess of Medicare Part D Benchmark to Apply as Medical Expense document. The document also provides the amount a person pays out of pocket for non-benchmark plans.
Standard Benefit Information
|
Cost Type |
2023 |
2024 |
|
Premium |
Varies |
Varies |
|
Annual Deductible |
$505 |
$545 |
|
Coinsurance Costs |
25% of drug costs between $505.01 and $4,660 (Cap of $7,400) |
25% of drug costs between $545.01 and $5,030 (Cap of $8,000) |
|
Coverage Gap Costs |
100% of costs between the initial coverage limit based on drug costs between $4,660.01 and $7,400.
|
100% of costs between the initial coverage limit based on drug costs between $5,030.01 and $8,000
|
|
Copayments |
|
|
Extra Help Full Subsidy Information
|
Cost Type |
2023 |
2024 |
|
Premium |
$0 |
$0 |
|
Annual Deductible |
$0 |
$0 |
|
Coinsurance Costs |
None |
None |
|
Coverage Gap Costs |
None |
None |
|
Copayments |
≤ 100% FPG
|
≤100% FPG
|
Extra Help Partial Subsidy Information
|
Cost Type |
2023 |
2024 |
|
Premium |
$0 |
$0 |
|
Annual Deductible |
$104 |
$0 |
|
Coinsurance Costs |
15% |
$0 |
| Copayments |
|
>100% FPG
|