Medicare Coverage Statistics
- Medicare is a federal program that provides health insurance for individuals aged 65 and older. It consists of three parts:
- Part A — Provides inpatient hospital coverage, skilled nursing facility care, some home health care, along with hospice care.
- Part B — Provides coverage for medically necessary outpatient hospital services, medical supplies, and preventative services.
- Part D — Prescription drug coverage.
- Medicare only pays for 80% of eligible medical expenses, which means you’ll have some out-of-pocket costs when visiting your physician or the hospital.
- Traditional Medicare also doesn’t cover routine dental, hearing, or vision care.
- In most instances, Medicare won’t cover health care received outside the United States, although some Medigap plans do provide this coverage.
- If you want to purchase coverage that bridges the gaps in Original Medicare, you can use a supplement (also called a Medigap) plan. However, these usually don’t provide coverage for prescription drugs. You can also purchase coverage through an Advantage plan, which replaces and expands the coverage provided under Original Medicare.
- Medicare Advantage (Part C) plans work similarly to traditional insurance by combining most of the coverage provided under Original Medicare and adding things like prescription medications not covered under Part D, along with other vision, hearing, wellness, and/or dental benefits. [6, 7, 9]
Medicare Enrollment Statistics
Millions of Americans rely on Medicare for their health care coverage, although a significant portion chooses to purchase Advantage plans instead of sticking with Original Medicare.
- In 2021, 63.3 million Americans were enrolled in Medicare. 55.1 million were eligible based on age and 8.3 million based on disability.
- 36.1 million individuals had Original Medicare during this same time, while 27.2 million signed up for Advantage plans. 48.5 million had Part D coverage.
- Medicare enrollment more than doubled between 2011 and 2021.
- Medicare Advantage enrollment by provider, as of 2020, is as follows:
- UnitedHealthcare: 26%
- Humana: 18%
- BCBS: 15%
- CVS Health: 11%
- Kaiser Permanente: 7%
- Centene: 4%
- Cigna: 2%
- All other insurers: 18%
- If you are already taking Social Security benefits, you will be automatically enrolled in Parts A and B.
- If you aren’t already taking SS benefits, you’ll have to sign up for Parts A and B during a seven-month window just before and after your 65th birthday.
- If you’re still working and have employer-based health insurance, you can delay signing up for Medicare until within eight months of losing coverage from your employer.
- If you don’t sign up for Medicare during your initial enrollment period, you could pay a 10% penalty for each year you were eligible but failed to enroll. This means that if you didn’t enroll for three years, you’d pay a 30% higher premium than someone who enrolled on time. [1, 4]
Medicare Cost Statistics
Medicare costs continue to rise each year. Although, between Original Medicare, Advantage plans, and Medigap plans, consumers are in a great position to obtain the coverage they need at prices they can afford.
- Most people don’t pay a premium for Part A coverage, but if you have to purchase it in 2021, you’ll pay between $259 and $471 per month, less any deductibles and coinsurance.
- The standard 2021 Part B monthly premium is $148.50 or higher, based on your income.
- Part D monthly premiums vary by plan, although the higher your income, the better your chances are of paying a higher premium for prescription drugs.
- When it comes to expanding coverage beyond Original Medicare, Medigap (supplement) options typically cost more than standalone Advantage plans. On the other hand, Advantage plans often feature more copays, potentially leaving you with greater out-of-pocket costs.
- In 2019 alone, the U.S. spent almost $800 billion on the Medicare program. Parts A and B—and hospital inpatient services, specifically—represented the largest part of total Medicare spending.
- Despite this outlay, the Medicare program also had about $800 billion in 2019 income, 80% of which was generated by general revenue and payroll taxes. Other sources of income are beneficiary premiums, state payments, social security benefit taxations, and interest.
- By 2022, total Medicare outlays are expected to grow to more than $1 trillion, representing 4.7% of the United States’ gross domestic product, which was up from 3.4% in 2018.
- Employees and their employers provide most of the money to support the Medicare program by contributing 1.45% of wages, each, or 2.9% total. If you’re self-employed, you’re responsible for the whole 2.9%. And if you make more than $200,000 per year, your employer will withhold an additional 0.9%. [2, 5, 8]
Which Medicare Questions Do You Have?
Medicare is a robust program that meets the needs of millions of Americans each year. But, where can you turn if you have questions about your coverage or the premiums you pay? The friendly staff at IHS Insurance Group is here to help!
Need a FREE Quote or have questions regarding Medicare or Medigap Coverage? We have three convenient ways to reach us:
- If you prefer to talk to a licensed agent directly, please call (866) 480-5063
- If you prefer to fill out a quick form and have an agent get back to you at your convenience, use the GET A FREE QUOTE tool.
- Lastly, for those that want an immediate quote, please click HERE.
Also, check out our Medicare FAQs here.
- Centers for Medicare and Medicaid Services. CMS Fast Facts. Accessed on 9/23/21.
- Statista. Medicare – Statistics & Facts. Accessed on 9/23/21.
- Centers for Medicare and Medicaid Services. Total Medicare Enrollment: Total, Original Medicare, and Medicare Advantage and Other Health Plan Enrollment, Calendar Years 2014-2019. Accessed on 9/23/21.
- Kaiser Family Foundation. A Dozen Facts About Medicare Advantage in 2020. Accessed on 9/23/21.
- IHS Insurance Group. How is Medicare Funded? Accessed on 9/27/21.
- IHS Insurance Group. How Does Medicare Work? Accessed on 9/27/21.
- IHS Insurance Group. Medicare Part C Coverage Basics. Accessed on 9/27/21.
- Medicare.gov. Medicare costs at a glance. Accessed on 9/27/21.
- IHS Insurance Group. What is Medicare Supplement (Medigap) Insurance? Accessed on 9/27/21.