Medicare Costs
Medicare costs can be a lot to keep track of! Let's break down the key out-of-pocket expenses so you can better understand what you might have to pay.
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Medicare Cost Terms
Premium
Costs that you will pay to Medicare or your insurance company each month.
Deductible
The out-of-pocket amount that you must pay before your insurance will begin to pay its share of Medicare-approved costs.
Coinsurance
The out-of-pocket amount for covered services; typically a percentage of the Medicare-approved cost.
Copayment
A set dollar amount for covered services or items.
Understanding Premium Costs
Medicare Part A
Medicare Part A is typically premium-free for those who've paid Medicare taxes for 10 years. Otherwise, monthly premiums apply: $285 for 30-39 quarters, and $518 for under 30 quarters in 2025.
Medicare Part B
The Medicare Part B premium is based on your household income. Most people pay the standard premium, which for 2025 is $185.
Medicare Part C
Medicare Advantage, or Part C, premiums can vary since these plans are offered by private insurance companies. However, according to CMS.gov the average monthly premium in 2025 for a Part C plan is $17.
Medicare Part D
Like Part C plans, Part D, or Prescription Drug plans, are sold through private insurance companies. The monthly premium for these plans can vary, but according to KFF.org, the average monthly premium for 2025 is $45.
Understanding Deductible Costs
Medicare Part A
In 2025, Part A has a $1,676 deductible per benefit period, which starts upon hospital admission and ends after 60 days without inpatient care. This can result in multiple deductibles within a year.
Medicare Part B
In 2025, the Part B Deductible is $257. Once you reach the deductible, your Part B coverage will kick in.
Medicare Part C
As you can expect, the Part C, or Medicare Advantage, deductible will vary depending on your plan. Some plans will have very high deductibles and low premiums, while some will be the reverse. There’s simply no way to tell without checking the details of your plan.
Medicare Part D
Although Part D deductibles will vary because they are offered by private plans, they can’t be higher than $590 per year in 2025, although they can be less.
Understanding Coinsurance Costs
Medicare Part A
Medicare Part A only requires a coinsurance for days 60+ of your inpatient care during a given benefit period. In 2025, this amounts to $419 per day for days 61-90, and $838 for days 90 and beyond for every lifetime reserve day.
Medicare Part B
Part B coinsurance is 20% of the approved cost for medically-necessary services, and Medicare pays the remaining 80%. There may be some services that Medicare covers in full, but you should expect to pay this 20% cost.
Medicare Part C
The Part C coinsurance will vary and you’ll have to check with your plan to see what the details are for you.
Medicare Part D
During your Part D initial coverage period, you can expect to pay 25% coinsurance, or copayment, towards the cost of your prescription drugs.
Understanding Copayment Costs
Unlike co-insurance, co-payments are usually a set dollar amount for covered services or items. Individuals with Medicare Advantage and Part D coverage typically pay a fixed dollar amount for services. Some plans charge both copays and coinsurance, but these are rare.
Common copays for a Medicare Advantage plan may be $15 for primary care visits and $30 to see a specialist within your network.
Most Part D plans have tiered pricing as a means to control costs. Copays rise along with the tiers. For example, your copay for prescriptions on the lowest tier may be only $1 to $3. Copays on the next tier may range from $5 to $12, then $15 to $30, and so on.
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