2022 Medicare Premiums, Deductibles, and Cost-Sharing Amounts

Part A (Hospital Insurance)

Hospital Deductible

Beneficiary pays:

per benefit period

Hospital Copayment

Beneficiary pays:

$389/day for days 61-90
$778/day per “lifetime reserve day” after day 90 of each benefit period (up to a maximum of 60 days over your lifetime)

Skilled Nursing Facility Copayment

Beneficiary pays:
  • $0 for the first 20 days of each benefit period
  • $194.50/day for days 21-100
  • All costs for each day after day 100 of the benefit period

Part A Premiums

Beneficiary pays:

Most people do not pay a monthly Part A premium because they or a spouse has 40 or more quarters of Medicare-covered employment.
$499/month for those with fewer than 30 quarters of Medicare-covered employment
$274/month for those with 30-39 quarters of Medicare-covered employment

Part B (Medical Insurance)

Annual Deductible

Beneficiary pays:

per benefit period

Part B Premium

Beneficiary pays:
for those with incomes below $87,000 if single, $174,000 if married** (higher incomes see below)

$170.10/month – standard Part B Premium

Most Part B covered services*

Beneficiary pays:

20% of amount Medicare approves

*Part B: covers Medicare eligible physician services, outpatient hospital services, outpatient mental health services, certain home health services, durable medical equipment


Medicare Advantage plans combine Part A and B into one plan.

Offered as a alternative to original Medicare, these plans are sold and serviced by Medicare-approved health insurance companies as an alternative option to your Original Medicare coverage. Premiums and out-of-pocket costs may vary depending on your plan, however most people pay as low as $0 to $25 in addition to your monthly Medicare Part B premium (see above). To ensure you find a plan that fits your specific healthcare needs and budget, please contact our licensed Medicare agent for professional assistance.


Monthly Premiums for Medicare Part D

For 2022 Medicare Part D Costs, most drug plans charge a monthly fee that varies by plan. You pay this in addition to the Part B premium. If you’re in a Medicare Advantage Plan (Part C) or Medicare Cost Plan with drug coverage, the monthly premium may include an amount for drug coverage.

  • If your income was more than $91,000 ($182,000 filing joint) you’ll pay $12.40 + your plan premium
  • If your income was more than $114,000 ($228,000 filing joint) you’ll pay $32.10 + your plan premium
  • If your income was more than $142,000 ($284,000 filing joint) you’ll pay $51.70 + your plan premium
  • If your income was more than $170,000 ($340,000 filing joint) you’ll pay $71.30 + your plan premium
  • If your income was more than $500,000 ($750,000 filing joint) you’ll pay $77.90 + your plan premium

Yearly Deductible

Deductibles vary between Medicare drug plans. Some Medicare drug plans don’t have a deductible.

-No Medicare drug plan may have a deductible more than $480 in 2022.

CoPayments and Out-of-Pocket Threshold

Once your deductible is met, you’ll pay a coinsurance (copay) for prescription drugs. Note that the amount of your copay may change during the benefit period, if the drug price fluctuates.

-Initial coverage limit is $4,430 (plan pays 75% – you pay 25%)

-Once you and your plan pay this amount, you’ll continue to pay 25% of the cost of your prescriptions drugs until you reach your threshold

-Annual out-of-pocked threshold is $7,050

Coverage Gap - Donut Hole

Once you and your plan have spent $4,430 on covered drugs in 2022, you’re in the coverage gap (a temporary limit on what the plan covers). Even though you’ll only pay 25% for both brand name and generic drugs at this point, almost the full price of the drug (except for what the plan pays) will count as out-of-pocket costs to help you get out of the coverage gap.

-The manufacturer pays 70% of drug costs
-The plan pays 5% of drug costs
-You pay 25% of drug costs
-The plan also pays 75% of a dispensing fee, you pay 25% of the dispensing fee

Catastrophic Coverage

Once you reach your threshold ($7.050), you are out of the coverage gap (donut hole) and you’ll automatically get catastrophic coverage. This assures you only pay a small coinsurance amount or copayment for covered drugs for the rest of the year.

-You’ll pay 5% or a small copay (whichever is greater) of the cost of your medications for the rest of the year.
-Your plan pays the rest

The above information was obtained from Medicare.gov.

Note that O’Brien & Associates, and Larry O’Brien are not part of the Federal Medicare program.