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Summary of Medicare Benefits and Cost-Sharing for 2023

California Health Advocates > The Basics > Summary of Medicare Benefits and Cost-Sharing for 2023

The chart below is a comprehensive list of Medicare Part A and B costs, including premiums, deductibles and coinsurance. Medicare supplemental insurance, known as Medigap, can help cover some of the gaps in coverage and pay for part or all of Medicare’s coinsurance and deductibles, depending on the policy. Some Medicare Advantage (MA) plans may also help cover these costs. See Medigap: Medicare Supplemental Insurance and Medicare Advantage for more information.

Comprehensive Part A (Hospital Insurance) Costs

Part A – Hospital Insurance Premiums, Deductibles & Coinsurance

If You HaveIn 2023, You Will Pay a Monthly Premium of
0-29 quarters of Social Security credits$506
30–39 quarters of Social Security credits$278
40 or more quarters of Social Security credits$0
Inpatient Hospital Deductible$1,600
Inpatient Hospital Coinsurance$400 per day for days 61–90
$800 per day for days 91-150
Skilled Nursing Facility Coinsurance$200 per day for days 21-100
Service ProvidedMedicare PaysYou Pay
Hospital Inpatient
Days 1-60100% after deductible$1,600 deductible
Days 61-90100% after copayment$400 per day copayment
60 Reserve Days1100% after copayment$800 per day copayment
After 150 Days0%100% for each day
Psychiatric HospitalSame as hospital inpatient (see above) with a 190-day lifetime limit100% after 190 days
Skilled Nursing Facility (SNF)
(if daily skilled care is needed after a 3-day hospital stay)
Days 1-20100%0%
Days 21-100100% after copayment$200 per day copayment
After 100 Days0%100%
Home Health Care100% minus 20% of covered medical equipment20% of Medicare-approved amount for medical equipment
Hospice Care100% minus $5 per prescription; 95% of Medicare-approved payment for respite care per dayCopayment of $5 per prescription; 5% of Medicare-approved payment for respite care per day, not to exceed $1,600
Blood (received during hospital or SNF stay)100% after first 3 pints of bloodFirst 3 pints of blood each year
1 Each of the 60 reserve days may be used only once during an individual’s lifetime.

Comprehensive Part B (Medical Insurance) Costs

Your Annual IncomeYour Monthly Premium For 2023
  • Single: up to $97,000
  • Couple: up to $194,000
$164.90
  • Single: $97,001 to $123,000
  • Couple: $194,001 to $246,000
$230.80
  • Single: $123,001 to $153,000
  • Couple: $246,001 to $306,000
$329.70
  • Single: $153,001 to $183,000
  • Couple: $306,001 to $366,000
$428.60
  • Single: $183,001 and over
  • Couple: $366,001 and over
$527.50
ServiceMedicare PaysYou Pay
Annual Deductible $226/yr.2
Physician Costs80% of approved amount20% of Medicare-approved amount, plus up to an additional 15% of the approved amount if the doctor or supplier does not accept assignment
Outpatient Hospital Care80% of approved amount$1,600 maximum
Clinical Lab ServicesApproved amount$0
Medical Equipment/Supplies80% of approved amountAll other costs
Certain Preventive Services (depending on the service, some are covered at certain intervals, such as once per year)80% or 100%20% of approved amount or $0, depending on the service
Mental Health Services
Partial Hospitalization
Days 1-60: 100% after deductible
Days 61-90: 100% after copayment
60 Reserve Days1: 100% after copayment
After 150 Days: 0%
Days 1-60: $1,600 deductible
Days 61-90: $400 per day copayment
60 Reserve Days: $800 per day copayment
After 150 Days: 100% for each day
Outpatient80% of approved amount20% of approved amount
2 Beneficiaries in Medicare Advantage plans do not pay the Part B annual deductible. Medigap Plans C and F include the Part B annual deductible as a benefit.

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Do you have comments or concerns about your Medicare coverage? Issues regarding getting your needed prescriptions from your Part D plan, or a Medicare Advantage plan representative's marketing practices? Let us know at comments@cahealthadvocates.org.

We are dedicated to making Medicare's program work well for all beneficiaries. Your feedback from your own or your client's concerns and experiences with Medicare, will guide our Medicare advocacy efforts with key policy and decision-makers in both California and nationally with the Centers for Medicare and Medicaid Services (CMS) and Congress.

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