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Costs: | What you pay in 2025: |
Part A Premium |
$0 for most people (because they paid Medicare taxes long enough while working - generally at least 10 years). This is sometimes called “premium-free Part A.” If you don’t qualify for a premium-free Part A, you might be able to buy it. In 2025, the premium is either $285 or $518 each month, depending on how long you or your spouse worked and paid Medicare taxes.
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Part A Deductible |
$1,676 for each time you’re admitted to the
hospital per benefit period, before Original Medicare
starts to pay. There's no limit to the number of benefit periods you can have. |
Inpatient stays (co-payments) |
Days 1-60: $0 after you pay your Part A deductible Days 61-90: $419 each day Days 91-150: $838 each day After day 150: You pay all costs |
Skilled Nursing Facility (co-payments) |
Days 1-20: $0 after you pay your Part A deductible Days 21-100: $209.50 each day After day 100: You pay all costs |
Costs: | What you pay in 2025: |
Part B Premium |
$185 each month (or higher depending on your
income). The amount can change each year. How much is the Part B late enrollment penalty?
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Part B Deductible |
You’ll pay $257, before Original Medicare starts to pay. You
pay this deductible once each year. |
Costs for services
(coinsurance) |
You’ll usually pay 20% of the cost for each Medicare-covered service or item after you’ve paid your deductible. |
Get help with Part A & Part B costs
If you have limited income and resources, you may be able to get help from your state to pay your premiums and other costs, like deductibles, coinsurance, and copays.
Drug coverage (Part D):
Costs: | What you pay in 2025: |
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Part D Premium |
Monthly premiums vary based on which plan you join. The
amount can change each year. You might pay a penalty if you:
How much is the Part D penalty?
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When you get prescription drugs |
Most plans charge a deductible, an amount you pay before the plan starts to pay, for prescriptions you fill. The deductible amount varies based on which plan you join. Your actual costs vary depending on the medicines you take, if they are on your plan’s list of covered drugs, and which pharmacy you use. |
Getting help with Medicare costs
Enrolling in Medicare during your initial enrollment period can help you avoid late enrollment penalties, which may raise your monthly costs.
When possible, you can lower your Medicare costs with one of the following programs:
- Manage your prescription drug costs by switching to a generic drug when possible.
- Apply for Extra Help, an assistance program for prescription drug coverage.
- Apply for copay relief or financial aid help from the Patient Advocate Foundation.
- Find out whether you qualify for Medicaid, a joint federal and state program that helps pay for medical costs.
- In Missouri: Apply for Medicare Savings Programs like the Qualified Medicare Beneficiary (QMB) Program or the Specified Low-Income Medicare Beneficiary (SLMB) Program. These are state-level discount programs for people with Medicare who meet a certain income limit.
Medicare Advantage Plan (Part C):
- Monthly premiums vary based on which plan you join. The amount can change each year.
- You must keep paying your Part B premium to stay in your plan.
- Deductibles, coinsurance, and co-payments vary based on which plan you join.
- Plans also have a yearly limit on what you pay out-of-pocket. Once you pay the plan’s limit, the plan pays 100% for covered health services for the rest of the year.
Medicare Supplement Insurance (Medigap):
- Monthly premiums vary based on which policy you buy, where you live, and other factors. The amount can change each year. Premiums generally range from about $100 to over $300 per month. Plans with higher premiums, like Plan G, typically have fewer out-of-pocket costs, while cost-sharing options like Plan K or L have lower premiums but require more expenses during care.
- You must keep paying your Part B premium to keep your supplement insurance.
- Helps lower your share of costs for Part A and Part B services in Original Medicare.
- Some Medigap policies include extra benefits to lower your costs, like coverage when you travel out of the country.
Generally, you only need to sign up for Part A and Part B once. Each year, you can choose which way you get your health coverage (and add or switch drug coverage).
Medicare is different from private insurance — it doesn’t offer plans for couples or families. You don’t have to make the same choice as your spouse.
2 steps to set up your Medicare coverage:
- Sign up for
- Part A (Hospital Insurance)
and
- Part B (Medical Insurance)
- Choose which way you want to get your Medicare health coverage
You can choose either of these for your health coverage.
- Original Medicare
- Medicare Advantage (Part C)
If you choose Original Medicare, you’ll also decide if you want drug coverage (Part D) and supplemental coverage, like Medigap
You’ll have Original Medicare unless you join a Medicare Advantage Plan.
Original Medicare includes two parts:
Original Medicare covers most, but not all of the costs for approved health care services and supplies. After you meet your deductible, you pay your share of costs for services and supplies as you get them. There’s no limit on what you’ll pay out-of-pocket in a year unless you have other coverage (like Medigap, Medicaid, employer, retiree, or union coverage).
- Part A (Hospital Insurance)
- Part B (Medical Insurance)
Services covered by Medicare must be medically necessary. Medicare also covers many preventive services, like shots and screenings. If you go to a doctor or other health care provider that accepts the Medicare-approved amount, your share of costs may be less. If you get a service that Medicare doesn’t cover, you pay the full cost.
With Original Medicare, you can:
- Go to any doctor or hospital that takes Medicare, anywhere in the U.S.
- Join a separate Medicare drug plan (Part D) to get drug coverage.
- Buy a Medicare Supplement Insurance (Medigap) policy to help lower your share of costs for services you get.
If you're not lawfully present in the U.S., Medicare won't pay for your Part A and Part B claims, and you can't enroll in a Medicare Advantage Plan or a Medicare drug plan.
Medicare Advantage bundles your Part A, Part B, and usually Part D coverage into one plan. Plans may offer some extra benefits that Original Medicare doesn’t cover — like vision, hearing, and dental services.
You join a plan offered by Medicare-approved private companies that follow rules set by Medicare. Each plan can have different rules for how you get services, like needing referrals to see a specialist. Costs for monthly premiums and services you get vary depending on which plan you join.
Plans must cover all emergency and urgent care, and almost all medically necessary services Original Medicare covers. Some plans tailor their benefit packages to offer additional benefits to treat specific conditions.
With Medicare Advantage, you:
- Need to use doctors who are in the plan’s network (for non-emergency or non-urgent care).
- May pay a premium for the plan in addition to the monthly Part B premium. Plans may have a $0 premium or may help pay all or part of your Part B premiums.
- Can’t buy separate supplemental coverage (like Medigap).
You must have both Part A and Part B to join a Medicare Advantage Plan.
How does Medicare work with my other insurance?
When you have Medicare and other health insurance (like from your job), one will pay first (called a “primary payer”) and the other second (called a “secondary payer”).
If you have other insurance, who pays first depends on a number of items, like if you’re still working, the type of insurance you have, and if you have a special situation, like End-Stage Renal Disease (ESRD).
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