Medicare costs: Key takeaways
When it comes to determining which Medicare coverage is right for your situation, there’s a long list of factors that you can and should consider.
But the actual costs of coverage are critical to consumers – and like most products and services, they change from year to year. Here’s a quick guide to the costs Medicare beneficiaries can expect in 2025 for each type of Medicare coverage.
(Note that while Medicare Advantage enrollees are still responsible for the Part B premium, the plan design and cost-sharing structure will be different under a Medicare Advantage plan; the following details for out-of-pocket costs under Medicare Parts A and B are specific to people who have Original Medicare.)
Medicare Part A (inpatient care)
2025 Medicare Part A premium:
- There is no Medicare Part A premium for most beneficiaries who paid into Medicare through payroll taxes (99% of Medicare beneficiaries do not have to pay a monthly premium for Medicare Part A).
- The Part A premium in 2025 is $285/month for those who worked / paid into Medicare between 7.5 and 10 years. (Work history can be yours or your spouse’s.)
- The Part A premium in 2025 is $518/month for those with a work history of less than 7.5 years.
2025 Part A deductible:
- The 2025 Medicare Part A deductible is $1,676, up from $1,632 in 2024.
- The Part A deductible covers up to 60 days in the hospital.
- The Part A deductible is per benefit period, NOT per year. Once a beneficiary has been out of the hospital for at least 60 days, a new benefit period would start if and when they needed to be hospitalized again.
2025 Part A daily copayments:
Part A copayments apply if and when you’re hospitalized for longer than 60 days, or spend more than 20 days in a skilled nursing facility after being discharged from the hospital. Here are the details:
- In 2025, the Part A copayment is $419 per inpatient day (days 61-90 in the benefit period for which the deductible applied).
- The Part A copayment is $838 per inpatient day for day 91 and beyond during a benefit period in 2025. These are your lifetime reserve days, and you only get 60 of them throughout your lifetime. They only start to be used up once you’ve spent 90 days in the hospital during a single benefit period. But if you do use up all your lifetime reserve days and don’t have supplemental coverage, you’re responsible for all hospital costs after the lifetime reserve days are used up. However, if you’re discharged, stay out of the hospital for at least 60 days, and then have to be readmitted, a new benefit period would begin and you’d only have to pay the Part A deductible for the first 60 days of inpatient care in the new benefit period.
- Medicare Part A covers 100% of the cost of skilled nursing facility care for the first 20 days, as long as you had at least a three-night inpatient hospital stay prior to the skilled nursing facility stay. After the first 20 days, your skilled nursing facility coinsurance in 2025 is $209.50 per day for days 21-100. (After that, Medicare no longer covers skilled nursing facility charges, so you’ll pay the full cost.)
Learn more about Medicare Part A.
Medicare Part B (outpatient care)
2025 Medicare Part B premiums:
2025 Part B deductible:
- Enrollees who receive Part B-covered treatment during the year must pay the Part B deductible, which is $257 in 2025, up from $240 in 2024.
- Medigap plans C and F will pay the Part B deductible for you, but they’re no longer available for newly eligible Medicare enrollees. People who were already eligible for Medicare prior to the start of 2020 can keep Plans C or F if they already have them, or enroll in them at a later date. But people who become eligible for Medicare on or after January 1, 2020 no longer have access to Medigap plans that cover the Medicare Part B deductible. (Plan G is still available for newly eligible enrollees; it’s the same as Plan F except enrollees cover the Part B deductible themselves.)
2025 Medicare Part B coinsurance:
Learn more about Medicare Part B.
Medigap
Medigap premiums:
Medigap out-of-pocket costs
- The out-of-pocket costs you’ll pay after your Medigap plan pays its share will depend on the plan design you select.
Medicare Part C (Medicare Advantage)
2025 Medicare Advantage premiums:
- If you have Medicare Advantage, you’ll pay the Part B premium ($185/month for most people in 2025) plus the Medicare Advantage premium for your coverage. Most Medicare Advantage plans include Part D drug coverage, so you don’t need to purchase a separate Part D plan if your Medicare Advantage plan covers drugs.
- The average 2025 Medicare Advantage premium is expected to be $17/month in 2025, down from $18.23/month in 2024. But the majority of Medicare Advantage enrollees pay no premiums other than their Part B premium. And although Medicare Advantage enrollees are responsible for paying the Part B premium, almost one in five Medicare Advantage plans pay at least a portion of their enrollees’ Part B premiums in 2024.
2025 Medicare Advantage maximum out-of-pocket:
- The Medicare Advantage maximum out-of-pocket in 2025 will increase to $9,350 for in-network costs (not counting prescription costs) This is an increase from $8,850 in 2024, but most plans have out-of-pocket caps well below the allowable maximum.
Learn more about Medicare Advantage.
Medicare Part D prescription drug coverage
2025 Medicare Part D premiums:
- Average premiums for stand-alone Part D prescription drug plans (PDPs) premiums are expected to be $40/month in 2025, which is a small decrease from 2024.
- There will continue to be a wide range of PDP premiums, varying from $0 to more than $100/month in most areas. But overall there are fewer PDPs available for 2025 than there were in 2024. Enrollees in a plan that’s ending will need to select a new plan to have coverage for 2025.
2025 Medicare Part D deductible:
- The maximum Part D deductible an enrollee will pay in 2025 is $590, up from $545 in 2024. (Some plans have no deductible at all.)
Part D out-of-pocket costs after deductible:
Learn more about Medicare Part D.
Medicare Extra Help
Medicare Extra Help beneficiary 2025 co-pays:
- Medicare Extra Help copays in 2025 will range from $1.60 to $12.15, depending on whether the drug is generic, preferred, brand-name, etc.
Learn more about Medicare Extra Help.
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.
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