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Paying for Medicare and Out-of-Pocket Costs

Generally, you can pay Medicare or Medicare-related insurance premiums in either of two ways:
  • in cash or with a check. In most cases, you need to mail this payment to your plan administrator by a set date (usually the 5th), each month. Some plans allow you to make payments, in person, at designated offices;
  • having the premium automatically deducted from your monthly Social Security check. Traditional Medicare will usually do this unless you ask it not to; most Medicare-related plan administrators prefer this option, too.

If your plan has not received your premium payment by the 15th of the month, the administrator will send you a notice telling you that your plan membership will end if it does not receive your premium within 90 days of the due date.

In addition to the monthly premium, there are two common types of out-of-pocket costs you may pay for services provided under Medicare:

  • a co-payment is the fixed amount you pay each time you receive certain medical services. You pay a co-payment at the time you get the medical service;
  • coinsurance is the percentage you pay of the total cost of certain medical services. You pay a coinsurance at the time you get the medical service.

Some people qualify for State Medicaid programs to help them pay their out-of-pocket costs for Medicare. These “Medicare Savings Programs” include the Qualified Medicare Beneficiary (QMB), Specified Low-Income Medicare Beneficiary (SLMB), Qualifying Individual (QI), and Qualified Disabled & Working Individuals (QDWI) programs. If you are enrolled in one of these programs, you may still have to pay a copayment for Medicare-related services.