Part A (Hospital Insurance)
Hospital Deductible
Beneficiary pays:
per benefit period
Hospital Copayment
Beneficiary pays:
$419/day for days 61-90
$838/day per “lifetime reserve day” after day 90 of each benefit period (up to a maximum of 60 days over your lifetime)
Skilled Nursing Facility Copayment
Beneficiary pays:
- $0 for the first 20 days of each benefit period
- $209.50/day for days 21-100
- All costs for each day after day 100 of the benefit period
Part A Premiums
Beneficiary pays:
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
Part B (Medical Insurance)
Annual Deductible
Beneficiary pays:
per benefit period
Part B Premium
Beneficiary pays:
$185.00/month – standard Part B Premium
Most Part B covered services*
Beneficiary pays:
20% of amount Medicare approves
*Part B: covers Medicare eligible physician services, outpatient hospital services, outpatient mental health services, certain home health services, durable medical equipment
MEDICARE PART C – ADVANTAGE PLANS
Medicare Advantage plans combine Part A and B into one plan.
Offered as a alternative to original Medicare, these plans are sold and serviced 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 most people pay as low as $0 to $25 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.
MEDICARE PART D – PRESCRIPTION DRUGS
Monthly Premiums for Medicare Part D
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 and Out-of-Pocket Threshold
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.
Some of the above information was obtained from Medicare.gov.
The above premiums represent national averages. Plan premiums can and do vary by state and by carrier.
Note that O’Brien & Associates, and Larry O’Brien are not part of the Federal Medicare program.
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.