I think it would be a good idea for seniors to learn how Medicare actually works and what you pay for and when you pay for it.
Part A is what you pay for during your working years with those payroll deductions and your employer match. It is basically the HI portion of your Medicare coverage - Hospital Insurance. This is also the one that has a Trust Fund which is slowly being depleted because of several reasons but I am not going to get into that now. The Social Security Trustees who analysis the SS and Medicare Trust Funds every year say that the Medicare HI Trust Fund will be declared insolvent in 2026 unless more money comes into it or less expenses come out of it. Now what that insolvency actually means is that it is an estimated time when the Trust Fund for Medicare Part A will reach a point when it will only be able to pay out 90% instead of 100% - meaning there is a shortfall that the law says when it reaches a certain point that it will only pay out a percentage of what is due to be paid.
Part B is the (SMI) Supplemental Medical Insurance part of Medicare - it pays for Doctors, other providers, lab work, vaccines, DME, and Infusion drugs done in an outpatient location. The SMI Medicare insurance is paid by the beneficiaries and the government. Normally, the split is 25% of the cost of the program is born by the beneficiaries in their Part B premiums and 75% of the cost is born by the government out of the General Fund. Don't forget that just because you are paying the normal premium ( $ 170.10 for 2022), many higher income folks are paying a whole lot more because of the Income Related Monthly Adjusted Amount (IRMMA) which ties their Part B premiums to their income (joint income if MFJ).
Infusion drugs covered by Part B are things like chemo therapy, drugs to treat rheumatoid arthritis and several others - these are the most expensive of drugs - many are life-saving or life extending. The new Alzheimer drug is one of those infusion drugs - it has yet to be approved by inclusion in Medicare - the FDA approved it in the fall of 2021 but there is lots of controversy about it. Cost being just one - A single treatment cost of $ 56,000 is just part of the cost that Medicare PART B will have to cover because people who might get it at a very specific time in their illness will also have to have many monitoring test during the therapy.
Part C - is in essence Medicare Advantage - it covers the same things that Traditional Medicare covers just in a differ way.
Part D is the Medicare Prescription Drug program - it works very similar to Medicare Part B.
Cost of Living Adjustment for many government income programs, including Social Security, is based on the Consumer Price Index that shows how prices are rising, falling or staying about the same. The period of time measured is Sept thru Sept. then announce in late Oct or Nov. each year.
The Social Security law contains a clause called the Hold Harmless Clause - that basically says that a beneficiary's Social Security benefit can NEVER be reduced from one year to the next because of Part B premiums. So in some years there is medical inflation (think 2020 COVID cost) yet if there is NO COLA or a relatively small one, premiums do not go up in relation to what they could have - the government pays a bigger share out of the general fund. Then when we do get a bigger one, they make up a bit of it - there is about $ 2.00 - $ 3.00 of this in the current increase in Part B premiums for 2022.
I know it is kind of confusing but it works the way it works - nothing in government is simple.
If you are low income, there are programs (called the Medicare Savings Programs) which helps people pay Part B & Part D premiums and much, if not all of their drug cost. It is what we do as a society - "Fair Share".
I could go further and tell you ways we could bring in more revenues into the programs - including Social Security. But for now - I have given you as simple an explanation as I can. It does help to understand how it all works together to create the whole Medicare program.
This is mostly about Part B premiums but if you want to discuss drug cost as in Part D - we can do that too. But again one has to understand how various programs work in order to discuss them.
It's Always Something . . . . Roseanna Roseannadanna