Costs

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 .

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

Part A (Hospital Insurance) costs

$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.”

Do I qualify for 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 $278 or $505 each month for Part A, depending on how long you or your spouse worked and paid Medicare taxes.

• 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.

$1,632 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. How do benefit periods work?

• Days 1-60: $0 after you pay your Part A deductible.
• Days 61-90: $408 each day.
• Days 91-150: $816 each day while using your 60 lifetime reserve days .
• After day 150: You pay all costs.

What's not covered?

What will I pay if I get mental health services as an inpatient?

• Days 1-20: $0.
• Days 21-100: $204 each day.
• Days 101 and beyond: You pay all costs.

$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)

$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.
  What if my hospice care doesn't pay for my drug?
• 5% of the Medicare-approved amount for inpatient respite care .
  What's not covered?

Part B (Medical Insurance) costs

$174.70 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.

Who pays a higher Part B premium because of income?

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.

• $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).

• $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.

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

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.

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.

Medicare Advantage Plan (Part C) costs

Varies by plan. These amounts can change each year.

Where can I get more cost details from my plan?

Part D (Drug Coverage) costs

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

Who pays a higher Part D premium because of 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).

Get help with drug costs
If you have limited income and resources, you may be able to get Extra Help to pay your plan premiums and other drug costs. If you qualify, you won’t have to pay the Part D late enrollment penalty. Learn more about help with costs.

Medicare Supplemental Insurance (Medigap)

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

• 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 to someone
• Get details: Learn about the parts of Medicare