Breakdown of Medicare Costs

Part A (Hospital Insurance)

  • Covers: Inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care.
  • Premiums: Most people do not pay a monthly premium for Part A if they or their spouse paid Medicare taxes through employment for a specified period (typically 10 years or 40 quarters).
    • 30–39 quarters: $283 (2025 estimated)
    • Less than 30 quarters: $514 (2025 estimated)
  • Deductible: $1,720 per benefit period (2025 estimated)
  • Coinsurance:
    • Days 1–60: $0 per benefit period
    • Days 61–90: $430 per day (2025 estimated)
    • Days 91+ (lifetime reserve days): $860 per day (2025 estimated, up to 60 lifetime reserve days)

Part B (Medical Insurance)

  • Covers: Doctor's services, outpatient care, medical supplies, and preventive services.
  • Premiums: $174.70 (2025 estimated standard premium).
    Income-Related Monthly Adjustment Amount (IRMAA): If your MAGI is above certain thresholds you pay more (based on 2023 MAGI). See tiers below:
    Individual Income Joint Income Part B Monthly Premium (2025 Estimated)
    $103,000 or less $206,000 or less $174.70
    $103,001 – $129,000 $206,001 – $258,000 $244.60
    $129,001 – $161,000 $258,001 – $322,000 $349.40
    $161,001 – $193,000 $322,001 – $386,000 $454.20
    $193,001 – $500,000 $386,001 – $750,000 $559.00
    Above $500,000 Above $750,000 $594.60
  • Deductible: $240 annual deductible (2025 estimated)
  • Coinsurance: After deductible, you typically pay 20% of the Medicare-approved amount for most services.

Part C (Medicare Advantage)

  • Covers: Combines Part A and Part B; often includes Part D and extra benefits like vision, dental, hearing.
  • Premiums: You still pay Part B premium; many Part C plans have their own additional monthly premium (varies by plan/location).
  • Deductibles/Copayments/Coinsurance: Vary significantly by plan.

Part D (Prescription Drug Coverage)

  • Covers: Prescription drugs. Offered by private companies approved by Medicare.
  • Premiums: Varies by plan.
    Income-Related Monthly Adjustment Amount (IRMAA): (based on 2023 MAGI) — additional Part D monthly amount:
    Individual Income Joint Income Part D Additional Monthly Amount (2025 Estimated)
    $103,000 or less $206,000 or less $0
    $103,001 – $129,000 $206,001 – $258,000 $12.90
    $129,001 – $161,000 $258,001 – $322,000 $33.30
    $161,001 – $193,000 $322,001 – $386,000 $53.80
    $193,001 – $500,000 $386,001 – $750,000 $74.20
    Above $500,000 Above $750,000 $80.80
  • Deductibles/Copayments/Coinsurance: Vary by plan and by coverage stage (deductible, initial coverage, coverage gap, catastrophic coverage).

Programs to Help with Costs

  • Medicare Savings Programs (MSPs): State-run programs that can help pay for Part A and/or Part B premiums, deductibles, and coinsurance for eligible low-income individuals.
  • Low-Income Subsidy (LIS) / Extra Help: Helps eligible individuals with Part D costs (premiums, deductibles, co-payments).

Note: All cost figures for 2025 are estimated and subject to change by the Centers for Medicare & Medicaid Services (CMS).