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âś” Medicare Part A (hospital) and Part B (medical)
âś” Medicare Savings Program (no cost)
âś” Extra Help for Prescription Drugs (no cost)
âś” Medicare Supplements, Medicare Advantage,
Part D Prescription Plans

Costs

What you pay for Medicare will vary based on what coverage and services you get, and what providers you visit. What are my coverage options?

There’s no yearly limit on what you pay out-of-pocket, unless you have supplemental coverage, like a Medicare Supplement Insurance (Medigap) policy, or you join a Medicare Advantage Plan.

Part A (Hospital Insurance) costs

Part A costs: What you pay in 2025:
Premium

$0 for most people (because they or a spouse paid Medicare taxes long enough while working – generally at least 10 years). If you get Medicare earlier than age 65, you won’t pay a Part A premium. This is sometimes called “premium-free Part A.”

If you don’t qualify for premium-free Part A: You might be able to buy it. You’ll pay either $285 or $518 each month for Part A, depending on how long you or your spouse worked and paid Medicare taxes.

Remember:

  • You also have to sign up for Part B to buy Part A. Learn more about how Medicare works.
  • If you don’t buy Part A when you’re first eligible for Medicare (usually when you turn 65), you might pay a penalty. Find out more about how to avoid the Part A penalty.
Deductible

$1,676 for each inpatient hospital benefit period, before Original Medicare starts to pay.

There’s no limit to the number of benefit periods you can have in a year. This means you may pay the deductible more than once in a year.

Inpatient stay
  • Days 1-60: $0 after you pay your Part A deductible.
  • Days 61-90: $419 each day.
  • Days 91-150: $838 each day while using your 60 lifetime reserve days.
  • After day 150: You pay all costs.
Skilled nursing facility stay 
  • Days 1-20: $0.
  • Days 21-100: $209.50 each day.
  • Days 101 and beyond: You pay all costs.
Home health care 

$0 for covered home health care services.

20% of the Medicare-approved amount for durable medical equipment (like wheelchairs, walkers, hospital beds, and other equipment)

Hospice care 

$0 for covered hospice care services.

You may also pay:

  • A copayment of up to $5 for each prescription drug and other similar products for pain relief and symptom control while you’re at home.
  • 5% of the Medicare-approved amount for inpatient respite care.
 

Part B (Medical Insurance) costs

Part B costs: What you pay in 2025:
Premium

$185 each month (or higher depending on your income). The amount can change each year. You’ll pay the premium each month, even if you don’t get any Part B-covered services.

You might pay a monthly penalty if you don’t sign up for Part B when you’re first eligible for Medicare (usually when you turn 65). You’ll pay the penalty for as long as you have Part B. The penalty goes up the longer you wait to sign up. Find out how the Part B penalty works and how to avoid it.

Deductible $257 before Original Medicare starts to pay. You pay this deductible once each year.
General costs for services (coinsurance)

Usually 20% of the cost for each Medicare-covered service or item after you’ve paid your deductible (and as long as your doctor or health care provider accepts the

Medicare-approved amount as full payment – called “accepting assignment”). Find out how assignment affects what you pay.

Clinical laboratory services $0 for covered clinical laboratory services.
Home health care
  • $0 for covered home health care services.
  • 20% of the Medicare-approved amount for durable medical equipment (like wheelchairs, walkers, hospital beds, and other equipment).
Inpatient hospital care 20% of the Medicare-approved amount for most doctor services while you’re a hospital inpatient.
Outpatient mental health care
  • $0 for your yearly depression screening.
  • 20% of the Medicare-approved amount for visits to your doctor or other health care provider to diagnose or treat your condition.
  • If you get your services in a hospital outpatient clinic or hospital outpatient department, you may have to pay an additional amount to the hospital.
Partial hospitalization mental health care

After you meet the Part B deductible:

  • 20% of the Medicare-approved amount for each service you get from a doctor or certain other qualified mental health professional
  • Coinsurance for each day of partial hospitalization services you get in a hospital outpatient setting or community mental health center
Outpatient hospital care
  • Usually 20% of the Medicare-approved amount for doctor and other health care providers’ services.
  • You’ll also pay a copayment to the hospital for each service you get in a hospital outpatient setting (except for certain preventive services). In most cases, your copayment won’t be more than the Part A hospital stay deductible amount.
    This additional hospital copayment means you may pay more for an outpatient service you get in a hospital than you’d pay if you got the same service in a doctor’s office.

Compare outpatient procedure costs under Original Medicare.

Get help with Part A & Part B costs
If you have limited income and resources, you may be able to get help from your state to pay your premiums and other costs. Learn more about help with costs.

Learn more about Medigap and its costs.

What do you want to do next?

  • Next Step: Get help with costs
  • Take Action: Talk to someone
  • Get details: Learn about the parts of Medicare

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Medicare Savings Programs

Get help from your state paying your Part A (Hospital Insurance) and Part B (Medical Insurance) premiums through a Medicare Savings Program. If you qualify, Medicare Savings Programs might also pay your Part A and Part B deductibles, coinsurance, and copayments.

You’ll apply for Medicare Savings Programs through your state. When you apply, your state determines which program(s) you qualify for. Even if you don’t think you qualify, you should still apply.

What’s a premium, deductible, coinsurance, or copayment?

How to qualify for the 4 Medicare Savings Programs

In many cases, to qualify for a Medicare Savings Program, you must have income and resources below a certain limit, as described below. These limits go up each year.

You may still qualify for these programs in your state even if your income or resources are higher than the federal limits listed. Some states don’t count certain types or specific amounts of income or resources when deciding who qualifies.

Contact Your State

Qualified Medicare Beneficiary (QMB) Program

Helps pay for: Part A premiums; Part B premiums, deductibles, coinsurance, and copayments (for services and items Medicare covers).

Monthly income and resource limits for 2025:

Your situation: Monthly income limit:*

Resource limit:

What counts in resource limits?

Individual $1,325 $9,660
Married couple $1,783 $14,470

* Income limits slightly higher in Alaska and Hawaii. You may qualify in other states for these programs even if your income or resources are higher than the federal limits listed. Contact your state to find out.

If you qualify for the QMB program:

  • Medicare providers aren’t allowed to bill you for services and items Medicare covers, including deductibles, coinsurance, and copayments. What should I do if I get a bill?
  • You may get a bill for a small Medicaid copayment, if one applies.
  • You’ll also get Extra Help paying for your prescription drugs. You’ll pay no more than $12.15 in 2025 for each drug covered by your Medicare drug plan.
Show both your Medicare card and Medicaid card (or QMB card) each time you get care. If you have Original Medicare, you can also show one of your claims statements, called Medicare Summary Notices. These statements show you’re in the QMB program. Get a sample of a Medicare Summary Notice.

Specified Low-Income Medicare Beneficiary (SLMB) Program

Helps pay for: Part B premiums (You must have both Part A and Part B to qualify.)

Monthly income and resource limits for 2025:

Your situation: Monthly income limit:*

Resource limit:

What counts in resource limits?

Individual $1,585 $9,660
Married couple $2,135 $14,470

* Income limits slightly higher in Alaska and Hawaii. You may qualify in other states for these programs even if your income or resources are higher than the federal limits listed. Contact your state to find out.

If you qualify for the SLMB Program: 

  • You’ll also get Extra Help paying for your prescription drugs.
  • You’ll pay no more than $12.15 in 2025 for each drug your Medicare drug plan covers.

Qualifying Individual (QI) Program

Helps pay for: Part B premiums (You must have both Part A and Part B to qualify.)

Monthly income and resource limits for 2025:

Your situation: Monthly income limit:*

Resource limit:

What counts in resource limits?

Individual $1,781 $9,660
Married couple $2,400 $14,470

* Income limits slightly higher in Alaska and Hawaii. You may qualify in other states for these programs even if your income or resources are higher than the federal limits listed. Contact your state to find out.

If you qualify for the QI program:

  • You must apply every year to stay in the QI Program.
  • States approve applications on a first-come, first-served basis – priority is given to people who got QI benefits the previous year.
  • You’ll also get Extra Help paying for your prescription drugs. You’ll pay no more than $12.15 in 2025 for each drug your Medicare drug plan covers

QI is only available for people who don’t qualify for any other Medicaid coverage or benefits, but you may qualify for help from another Medicare Savings Program.

Qualified Disabled & Working Individual (QDWI) Program

You may qualify for the QDWI Program if you:

  • Have a disability
  • Are working
  • Lost Your Social Security disability benefits and Medicare premium-free Part A because you returned to work

Helps pay for: Part A premiums only

Monthly income and resource limits for 2025:

Your situation: Monthly income limit:*

Resource limit:

What counts in resource limits?

Individual $5,302 $4,000
Married couple $7,135 $6,000

* Income limits slightly higher in Alaska and Hawaii. You may qualify in other states for these programs even if your income or resources are higher than the federal limits listed. Contact your state to find out.

How to apply for a Medicare Savings Program

These programs are run by your state. Contact your state to apply.

What do you want to do next?

  • Next Step: Lower your drug costs
  • Take Action: Talk to someone
  • Get details: Learn about Medicaid

What’s Extra Help?

“Extra Help" is a Medicare program to help people with limited income and resources pay Medicare drug coverage (Part D) premiums, deductibles, coinsurance, and other costs.

You also won’t have to pay a Part D late enrollment penalty while you get Extra Help.

Some people qualify for Extra Help automatically, and other people have to apply.

Extra Help isn’t available in Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, or American Samoa. But there are other programs available in those areas to help people with limited income and resources. Programs vary in these areas. Call your State Medical Assistance (Medicaid) office to learn more.

Who gets Extra Help automatically?

You’ll get Extra Help automatically if you get:

You’ll get a letter about your Extra Help. It tells you things like how much you’ll pay, and your new Medicare drug plan, if you don’t have one already.

If you don’t get Extra Help automatically , you can apply for it:

Apply for Extra Help

You can also contact your local State Health Insurance Assistance Program (SHIP) to get free help applying.

You can apply for Extra Help and Medicare Savings Programs (MSPs) at the same time. These state programs provide help with other Medicare costs. Social Security will send information to your state to initiate an MSP application unless you tell them not to on the Extra Help application. Learn more about Medicare Savings Programs.

Who should apply for Extra Help?

In most cases, to qualify for Extra Help, you must have income and resources below a certain limit. These limits may go up each year.

Income and resource limits in 2025:

Your situation: Income limit: Resource limit:
Individual $23,475 $17,600
Married couple $31,725 $35,130

If you qualify for Extra Help

We’ll automatically enroll you in a

, if you don’t have one already. We do this so you can get the cost savings you qualify for.

  • You’ll get a letter telling you:
    • About your new plan. You can pick a different Medicare drug plan if you want.
    • That you get Extra Help for the rest of the calendar year. Even if your income changes in the middle of the year, you’ll keep getting Extra Help through December 31.
  • If you meet the income and resource limits for next year, you’ll keep getting Extra Help. We’ll mail you a letter only if:
    • You no longer qualify for Extra Help.
    • You get moved to a different plan for next year.
  • If you don’t get a letter from Medicare or Social Security, you’ll keep getting Extra Help and keep the same plan for next year.

What you’ll pay under Extra Help in 2025

  • Plan premium: $0
  • Plan deductible: $0
  • Prescriptions you fill at one of your plan’s participating pharmacies:
    • Up to $4.90 for each generic drug
    • Up to $12.15 for each brand-name drug

    Once your total drug costs (including certain payments made on your behalf, like through the Extra Help program) reach $2,000, you’ll pay $0 for each covered drug.

If you also get full Medicaid coverage and are in the Qualified Medicare Beneficiary (QMB) program, you’ll pay no more than $4.80 for each covered drug. Find out if you may qualify for QMB or other Medicare Savings Programs.

Learn more about the letters you get when you qualify for Extra Help.

Even if you don’t qualify for Extra Help now, you can reapply for Extra Help any time if your income and resources change.

Costs

What you pay for Medicare will vary based on what coverage and services you get, and what providers you visit. What are my coverage options?

There’s no yearly limit on what you pay out-of-pocket, unless you have supplemental coverage, like a Medicare Supplement Insurance (Medigap) policy, or you join a Medicare Advantage Plan.

Medicare Advantage Plan (Part C) costs

Medicare Advantage Plan costs: What you pay in 2025:
Premiums & other costs (like deductibles, copayments, & coinsurance)

Varies by plan. These amounts can change each year.

You must have Part B and keep paying your Part B premium to stay in your plan.
 
Out-of-pocket limit Varies by plan. Once you pay the plan’s limit, the plan pays 100% of your covered health services for the rest of the calendar year.

Part D (Drug Coverage) costs

Part D costs: What you pay in 2025:
Premium

Varies by plan. You may have to pay more, depending on your income.

Avoid paying a penalty:

  • Join a Medicare drug plan when you first get Medicare Part A and/or Part B, and Don’t go 63 days or more without creditable drug coverage
     (coverage that’s similar in value to Part D).
Deductibles, copayments, & coinsurance Varies by plan and pharmacy. Find Medicare drug plans in your area, and compare their costs and coverage.

Get help with drug costs
If you have limited income and resources, you may be able to get

to pay your plan premiums and other drug costs. If you qualify, you won’t have to pay the Part D late enrollment penalty.

   

Medicare Supplemental Insurance (Medigap)

Medigap costs: What you pay in 2025:
Premium

Varies based on which Medigap policy you buy, where you live, and other factors. The amount can change each year.

You must have Part B and keep paying your Part B premium to keep your Medigap policy.
Other costs
  • Medigap usually helps pay your portion of the costs (like deductibles and coinsurance) for services that Part A and Part B cover in Original Medicare. The amount you’ll pay for Part A and Part B services if you have a Medigap policy varies depending on the policy you buy.
  • Some Medigap policies include extra benefits to lower your costs, like coverage when you travel out of the country.

What do you want to do next?

  • Next Step: Get help with costs
  • Take Action: Talk with one of our local licensed agents that will never charge you a service fee today.
  • Get details: Learn about the parts of Medicare