Breakdown of Costs
Original Medicare
Medicare Part A (Hospital Insurance) Costs for 2025
Part A covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health services. While most beneficiaries don’t pay a premium for Part A due to having paid Medicare taxes during their working years, there are still other costs involved:
- Premium: Most beneficiaries pay $0 per month. However, if you or your spouse didn’t pay Medicare taxes for at least 40 quarters, you may pay up to $506 per month.
- Deductible: The inpatient hospital deductible is $1,676 per benefit period (60 days). This means you pay this amount before Medicare starts to pay its share.
- Coinsurance:
- Days 1–60: $0 per day.
- Days 61–90: $419 per day.
- Days 91 and beyond: $838 per day (using lifetime reserve days).
- Skilled Nursing Facility (SNF) Care:
- Days 1–20: $0 per day.
- Days 21–100: $209.50 per day.
- Days 101 and beyond: All costs are your responsibility.
Medicare Part B (Medical Insurance) Costs for 2025
Part B covers doctors and outpatient services, including doctor visits, outpatient hospital services, labs, diagnostic tests, radiology, certain home health services, durable medical equipment, and some preventive services.
- Premium: The standard monthly premium is $185.00. However, if your income is above a certain threshold, you may pay an Income Related Monthly Adjustment Amount (IRMAA), increasing your premium up to $628.90 per month.
- Deductible: The annual deductible is $257.
- Coinsurance: After meeting your deductible, you typically pay 20% of the Medicare-approved amount for most services.
Additional Costs and Considerations
No Out-of-Pocket Maximum: Original Medicare doesn’t have a cap on out-of-pocket expenses. Without additional coverage, you could face significant costs for services.
Prescription Drug Coverage: Original Medicare doesn’t cover most prescription drugs. To get this coverage, you need to enroll in a Medicare Part D plan, which has its own premiums, deductibles, and cost-sharing. These are offered as either stand-alone Part D plans or included in many Medicare Advantage Plans (Part C).