How to Budget for Medicare

How to Budget

Medicare costs can change every year. This can be a problem for older adults that are on a limited or fixed income. It’s important to know how to budget for any and all Medicare costs. By knowing what your projected Medicare costs are each year can help you to plan ahead and minimize out-of-pocket spending.

Budgeting Medicare coverage and your other costs

Once you know what you’re expected Medicare cost-sharing expenses will be, there are other factors that will affect your out-of-pocket costs. You should consider the following when budgeting for Medicare payments:

  • Your individual health needs: Your specific health conditions and medications, along with which health services you need and how often you need them will all affect how much you pay.
  • Using in-network doctors and providers: It is generally less expensive to stay in your plan’s network. However, the list of included providers can change every year, so always verify that your providers are still in-network.
  • Using Medicare-participating providers: Medicare-participating providers are required to accept assignment for services, meaning they cannot charge you more than the Medicare-approved amount.
  • If you have other insurance: If you have other coverage, like through an employer group plan, it may cover services and costs that Medicare doesn’t. To see how your insurance works with Medicare, check with your health benefits administrator.
  • Eligibility for financial assistance: If you qualify for Medicaid, Medicare Savings Programs, and/or Extra Help with prescription drug costs and coverage, you could receive help paying for your Medicare and prescription drug costs.

Medicare cost-sharing requirements can change from year to year, so budgeting for Medicare payments should be adjusted as such. 

Beneficiaries taking prescription medications have more to gain by researching options each year. Medicare Advantage Prescription Drug plans and stand-alone Medicare Part D Prescription Drug Plans can change their premiums every year as well. Medicare plans providing prescription drug coverage can vary in costs, depending on the medications you take, your ability to use a generic equivalent prescription drug rather than a brand name medication, and your use of the plan’s preferred pharmacies.

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