Part A (Hospital)
Inpatient Hospital Stay — You Pay
- Deductible: $1,736 per benefit period
- Coinsurance (days 1–60): $0 per day of each benefit period
- Coinsurance (days 61–90): $434 per day of each benefit period
- Coinsurance (60 lifetime reserve days): $868 per day after day 90 of each benefit period
Skilled Nursing Facility Stay — You Pay
(3‑day inpatient hospital stay required first)
- Coinsurance (days 1–20): $0 per day of each benefit period
- Coinsurance (days 21–100): $217 per day of each benefit period
Part B (Medical)
- Part B Deductible — You Pay: $283 per calendar year
- Part B Coverage — You Pay: Generally 20% after the $283 deductible is met
Part B Premium
(including high income Part B and Part D amounts paid to Medicare)
- Everyone enrolled in Part B pays at least the standard $202.90/month premium.
- Higher income enrollees pay a Part B IRMAA in addition to the $202.90 standard premium.
- Higher income enrollees with Part D coverage also pay a Part D IRMAA in addition to their plan’s monthly premium.
If your MAGI (Modified Adjusted Gross Income) in 2024 was…
| Individual Tax Return | Joint Tax Return | Married & Separate Tax Return | Part B Premium + IRMAA (2026) | Part D IRMAA (add to plan premium) |
|---|---|---|---|---|
| $109,000 or less | $218,000 or less | $109,000 or less | $202.90 | — |
| $109,001 to $137,000 | $218,001 to $274,000 | N/A | $284.10 (202.90 + 81.20) | + $14.50 |
| $137,001 to $171,000 | $274,001 to $342,000 | N/A | $405.80 (202.90 + 202.90) | + $37.50 |
| $171,001 to $205,000 | $342,001 to $410,000 | N/A | $527.50 (202.90 + 324.60) | + $60.40 |
| $205,001 to $499,999 | $410,001 to $749,999 | $109,001 to $399,999 | $649.20 (202.90 + 446.30) | + $83.30 |
| $500,000+ | $750,000+ | $391,000+ | $689.90 (202.90 + 487.00) | + $91.00 |
*MAGI = Adjusted Gross Income (Form 1040 line 11) + Tax‑Exempt Interest (Form 1040 line 2a).
Official Medicare calculator: medicare.gov/eligibilitypremiumcalc
Medicare Savings Programs (MSP) — Washington State
These state programs can pay some or all of your Medicare costs. You can be on standard Medicare or a Medicare Advantage plan. No estate recovery applies.
To figure out if you qualify, take your gross monthly household income and subtract $20 (one deduction per household). Compare that number to the chart below.
Programs at a glance
- QMB (Qualified Medicare Beneficiary) — Pays Part A and Part B premiums, deductibles, and co-payments (except prescriptions)
- SLMB (Specified Low-Income Medicare Beneficiary) — Pays Part B premium
- QI-1 (Qualified Individual) — Pays Part B premium
- QDWI (Qualified Disabled Working Individual) — Pays Part A premium
Income limits (effective 1/19/2026)
| Program | Income limit (single) | Income limit (married) | What it pays |
|---|---|---|---|
| QMB (≤110% FPL) | ~$1,455/mo · ~$17,460/yr | ~$1,967/mo · ~$23,604/yr | Part A & B premiums + deductibles, copays, coinsurance |
| SLMB (110–120% FPL) | ~$1,586/mo · ~$19,032/yr | ~$2,144/mo · ~$25,728/yr | Part B premiums |
| QI-1 (120–138% FPL) | ~$1,821/mo · ~$21,852/yr | ~$2,461/mo · ~$29,532/yr | Part B premiums (until federal funding runs out) |
| QDWI (138–200% FPL) | ~$2,628/mo · ~$31,536/yr | ~$3,553/mo · ~$42,636/yr | Part A premiums (must be under 65, employed, disabled) |
Income limits above are approximate annual figures based on 2026 FPL ($15,650 single / $21,150 couple) multiplied by the relevant percentage, plus the $20/month general income exclusion. The state uses SSI-related income counting rules (chapter 182-512 WAC), which allow certain deductions and exclusions, so a person whose gross income is slightly over the limit may still qualify after deductions.
*QDWI has special earned-income deductions — call DSHS for help determining eligibility.
How to apply
- Find a local Community Services Office: dshs.wa.gov/officelocations
- Apply online: washingtonconnection.org
- Call HCA: 1-800-562-3022, ext. 16129 to request a paper application