Medicare Costs: What You'll Actually Pay

Part A costs (2025)

Most people pay $0 in Part A premiums if they have 40+ quarters of Medicare taxes. If you have fewer quarters, premiums range from $285 to $518 per month depending on how many quarters you have. Even with $0 premiums, you still pay deductibles and coinsurance.

• Inpatient deductible: $1,676 per benefit period (not per year). A new benefit period starts after you have been out of the hospital for 60 consecutive days.
• Days 1-60: $0 coinsurance after the deductible.
• Days 61-90: $419/day coinsurance.
• Lifetime reserve days: $838/day coinsurance for up to 60 lifetime reserve days.

Part B costs (2025)

The standard Part B premium is $185.00 per month. Higher-income beneficiaries pay an IRMAA surcharge on top of the standard premium. Part B has a $257 annual deductible, after which Medicare covers 80% of approved costs and you pay 20%. There is no annual out-of-pocket cap with Original Medicare alone.

IRMAA: Income-related adjustments

If your modified adjusted gross income (MAGI) from two years prior exceeds certain thresholds, you pay more for Parts B and D. IRMAA is reassessed annually and can add anywhere from $74.00 to $443.90 per month to your Part B premium in 2025. If your income has dropped significantly since the year CMS used, you can appeal your IRMAA.

Original Medicare has no out-of-pocket cap

This is the most important cost fact most beneficiaries do not know. With Original Medicare alone, there is no limit on how much you can owe in a given year. A serious illness requiring long hospitalization can result in tens of thousands of dollars in cost-sharing. This is the primary reason most people add either a Medigap plan (which covers most cost-sharing) or a Medicare Advantage plan (which has a statutory annual out-of-pocket maximum).

Extra Help and Medicare Savings Programs

If your income and assets are below certain thresholds, you may qualify for programs that reduce or eliminate your Medicare costs. Extra Help (Low Income Subsidy) reduces Part D premiums, deductibles, and copays. Medicare Savings Programs can pay your Part B premium and sometimes your Part A deductible. Talk to an Advocate about whether you qualify.

Common questions