Medicare Costs

Understanding the costs of Medicare is just as important as understanding your coverage. While Medicare helps cover many healthcare expenses, it’s not completely free. There are premiums, deductibles, and out-of-pocket costs to consider.

The good news? You can plan ahead, reduce your costs, and even get financial assistance if you qualify.

The key is knowing what to expect and how to protect yourself from high out-of-pocket expenses. Let’s break it down—so you can make the best Medicare choices with confidence and peace of mind.

Premiums, Deductibles, and Out-of-Pocket Costs

Medicare Part A (Hospital Insurance)

Cost Category	Your Cost (2025)
Monthly Premium (Most people)	$0
Monthly Premium (If you haven’t worked 10+ years)	Up to $518/month
Hospital Deductible	$1,676 per benefit period
Hospital Stay (Days 1-60)	$0 after deductible
Hospital Stay (Days 61-90)	$419 per day
Hospital Stay (91+ days, using lifetime reserve days)	$838 per day
Beyond Lifetime Reserve Days	Full cost (no Medicare coverage)
Skilled Nursing Facility (Days 1-20)	$0
Skilled Nursing Facility (Days 21-100)	$209.50 per day
Skilled Nursing Facility (After 100 days)	Full cost
Out-of-Pocket Maximum	No limit*

*There is no annual cap on what you might pay under Part A unless you have a Medigap or Medicare Advantage plan.

 Medicare Part B (Medical Insurance)

Cost Category	Your Cost (2025)
Monthly Premium	$185/month
Annual Deductible	$257 per year
Doctor Visits & Outpatient Care	20% coinsurance after deductible
Out-of-Pocket Maximum	No limit*

*Medicare only covers 80% of doctor visits and outpatient care—the rest is your responsibility unless you have extra coverage.

 Medicare Part D (Prescription Drug Plans)

Cost Category	Your Cost (2025)
Monthly Premium	Varies by plan (~$46.50 average)
Annual Deductible	Up to $590
Out-of-Pocket Maximum	$2,000 cap in 2025*

*Starting in 2025, Medicare will limit your yearly prescription drug costs to $2,000. Once you hit this amount, Medicare pays 100% of your drug costs for the rest of the year.

How to Lower Your Medicare Costs

Medicare costs can add up, which is why it’s essential to know these strategies for saving money.

1. Compare Medicare Plans Every Year

Medicare plans change annually—so do your healthcare needs. Reviewing your plan during Open Enrollment (Oct 15 – Dec 7) could save you hundreds or even thousands of dollars.

2. Consider a Medicare Advantage Plan

Medicare Advantage (Part C) bundles hospital, doctor, and drug coverage into one plan—often with extra benefits like dental, vision, and hearing coverage. Some plans even have $0 monthly premiums.

3. Use Preventive Services

Medicare covers many preventive screenings and annual check-ups for free. Taking advantage of these can help you avoid costly health issues down the road.

4. Choose Generic Medications When Possible

Generic drugs cost significantly less than brand-name prescriptions. Always ask your doctor or pharmacist about lower-cost alternatives.

5. Get Help Paying for Medicare

Many people qualify for programs that help pay for Medicare premiums, deductibles, and drug costs—keep reading to see if you’re eligible.

Financial Assistance Options (Low-Income Subsidy)

If you’re worried about affording Medicare, you may qualify for financial help. These programs can lower or even eliminate your Medicare premiums, deductibles, and copays.

1. Extra Help (Low-Income Subsidy for Medicare Part D)

Extra Help is a federal program designed to lower the cost of prescription medications for those with limited income and resources. Here are the benefits:

• Covers Medicare Part D premiums, deductibles, and copayments.
• Reduces prescription drug costs to no more than $4.90 for generics and $12.15 for brand-name drugs.
• Allows eligible individuals to enroll in a Part D plan at any time without waiting for an enrollment period.

To qualify in 2025, individuals must have an annual income below $23,475, and married couples must have an income below $31,725. Asset limits of $17,600 for individuals and $35,130 for married couples also apply.

2. Medicare Savings Programs

Medicare Savings Programs (MSPs) help with Medicare Part A and Part B costs for low-income individuals. These state-run programs may cover monthly premiums, deductibles, and other cost-sharing expenses.

• Some programs pay only the Part B premium, while others cover both Part A and Part B costs.
• Eligibility is based on income and varies by state.
• Applying through your state Medicaid office is required to determine if you qualify.

3. Medicaid for Medicare Beneficiaries

Medicaid provides additional healthcare coverage for individuals who qualify based on income and resources. Some people are eligible for both Medicare and Medicaid, which means Medicaid may cover costs that Medicare does not—like long-term care and additional medical services:

• Medicaid may cover Medicare premiums, deductibles, and copays for those who qualify.
• Each state has different eligibility requirements and benefits.
• You can apply for Medicaid through your state’s Medicaid office.

Not sure whether you’d qualify for financial assistance? Our Medicare specialists can review the requirements and guide you through the application. These programs are designed to make healthcare more affordable, so why not see if you qualify?

Need Help Figuring Out Your Medicare Costs?

No one should have to choose between the healthcare they need and what they can afford. And when you’re worried about Medicare costs, it’s hard to make a rational, well-informed decision about your coverage.

Know that there are real solutions, and we’re here to help you find them. Let’s make sure you get the coverage you deserve without the stress.