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Medicare Costs

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National Average Premiums for Medicare

When you turn 65 you will become eligible for Medicare.  If you are wondering how much you will pay for Medicare coverage, following are the national average premiums for Medicare. Note that most people do not pay for Part A, but will pay a premium for Part B and D.   It’s important to note that while Medicare premiums are the same in many states across the US, rates can and do vary in some other states, and depending the type of Medicare coverage you have, as well as what health insurance company is approved for your area. We encourage you to call our office for a more accurate picture of your total costs.

2025 Costs

Medicare Premiums Beneficiary Pays for Part A Monthly Premium

Most people do not pay a monthly Part A premium because they or a spouse has 40 or more quarters of Medicare-covered employment.

  • $518/month for those with fewer than 30 quarters of Medicare-covered employment
  • $285/month for those with 30-39 quarters of Medicare-covered employment
Beneficiary Pays for Skilled Nursing Facility Stay
  • $0 for the first 20 days of each benefit period
  • $209.50 per day for days 21–100 of each benefit period
  • All costs for each day after day 100 of the benefit period
Beneficiary Pays for Hospital Stay
  • $1,676 deductible per benefit period
  • $0 for the first 60 days of each benefit period
  • $419 per day for days 61–90 of each benefit period
  • $838 per “lifetime reserve day” after day 90 of each benefit period (up to a maximum of 60 days over your lifetime)
2025 Costs

Medicare Premiums Beneficiary Pays for Part B Monthly Premium 

Most people pay the standard Part B premium amount which is $185.00 in 2025

  • If your income was more than $106,000 ($212,001 filing joint) you’ll pay $259.00
  • If your income was more than $133,000 ($266,001 filing joint) you’ll pay $370.00
  • If your income was more than $167,001 ($334,001  filing joint) you’ll pay $480.90
  • If your income was more than $200,001 ($400,001 filing joint) you’ll pay $591.90
  • If your income was more than $500,000 ($750,000 filing joint) you’ll pay $628.90
Beneficiary Pays for Part B Services
  • $257.00 deductible per benefit period
  • After your deductible is met, you typically pay 20% of the Medicare-approved amount for most doctor services (including most doctor services while you’re a hospital inpatient), outpatient therapy, outpatient mental health services, certain home health services, and durable medical equipment
2025 Costs

Medicare Advantage Plans (Part C)

Medicare Advantage plans combine Part A and B into one plan and are offered by Medicare-approved health insurance companies as an alternative option to your Original Medicare coverage. Premiums and out-of-pocket costs may vary depending on your plan, however some premiums can be as low as $0, in addition to your monthly Medicare Part B premium (see above). To ensure you find a plan that fits your specific healthcare needs and budget, please contact our licensed Medicare agent for professional assistance.

2025 Costs

Part D (Prescription Drug) Costs

Monthly Premium

For 2025 Medicare Part D Costs, most drug plans charge a monthly fee that varies by plan. You pay this in addition to the Part B premium. If you’re in a Medicare Advantage Plan (Part C) or Medicare Cost Plan with drug coverage, the monthly premium may include an amount for drug coverage.

-If your income was more than $106,000 ($212,000 filing joint) you’ll pay $13.70 + your plan premium
-If your income was more than $133,000 ($266,000 filing joint) you’ll pay $35.30 + your plan premium
-If your income was more than $167,000 ($334,000 filing joint) you’ll pay $57.00 + your plan premium
-If your income was more than $200,000 ($400,000 filing joint) you’ll pay $78.60 + your plan premium
-If your income was more than $500,000 ($750,000 filing joint) you’ll pay $85.80 + your plan premium

Yearly Deductible

Deductibles vary between Medicare drug plans. Some Medicare drug plans don’t have a deductible.

  • No Medicare drug plan may have a deductible more than $590 in 2025.
Copayments & Out-of-Pocket Thresholds

New in 2025, since they have eliminated the Donut Hole in 2025, once your deductible is met, you’ll pay a coinsurance (copay) for prescription drugs. 

-Initial coverage limit is $2,000. Once you reach this amount, you’ll automatically get catastrophic coverage and won’t have to pay out-of-pocket for covered Part D drugs for the rest of the year.

Catastrophic Coverage

Once you reach your threshold ($2,000), you won’t have to pay out-of-pocket for covered Part D drugs for the rest of the year.

Insulin Costs

In 2025, Medicare Part D will limit insulin copayments to $35 per month for covered prescriptions:
• This applies to insulin received through durable medical equipment, such as insulin pumps, through Medicare Part B
• There is no deductible
• The $35 limit applies even if you get Extra Help to lower your prescription drug costs
• A 3-month supply of insulin costs no more than $105

Costs for Vaccines

Starting in 2023, vaccines covered under Medicare Part D will be free. This means you pay no deductible, coinsurance or copay for vaccines — even the shingles vaccine — as well as RSV, Tetanus, Whooping Cough, Flu and Covid 19 — all covered by Medicare Part D.

Disclaimers:

The above premiums represent national averages. Plan premiums can and do vary by state and by carrier.

The above information on Medicare costs was retrieved from Medicare.gov.

Healthfirm Benefits, nor it’s agents, are not part of the Federal Government Medicare System. The content in on this page has not been reviewed or approved by Medicare.

We do not offer every plan available in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program to get information on all your options.

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