Medicare Part A (Hospital Insurance)

Part A monthly premium

Most people don’t pay a premium for Part A because they or a spouse already paid for Medicare through their payroll taxes while working. If you don’t get premium-free Part A, you pay up to $518 each month. If you don’t buy Part A when you’re first eligible for Medicare (usually when you turn 65), you might pay a penalty.

Hospital Stay

In 2025, you pay:

$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)

Skilled Nursing Facility stay:

In 2025, you pay:

$0 for the first 20 days of each benefit period
$209.50 per day for days 21–100 of each benefit period
No coverage day after day 100 of the benefit period

It also helps cover hospice care and some home health care. Must meet certain conditions to get these benefits.

Medicare Part B (Medical Insurance)

Part B monthly premium –

Most people pay the standard Part B monthly premium amount ($185 in 2025). Social Security will tell you the exact amount you’ll pay for Part B in 2025. This is deducted from your Social Security benefits, if you receive benefits. If you do not, you are directly billed for your Part B premiums three months at a time.

If your modified adjusted gross income as reported on your IRS tax return from 2 years ago is above a certain amount, you’ll pay the standard Part B premium and an income-related monthly adjustment amount IRMAA.

Medical

In 2025, you pay:

Deductible: $257 deductible per calendar year
Copayments/Coinsurance: These cost-sharing fees are required for certain services/equipment. The typical rate is 20%, but this is subject to change depending on the service and is limited under Medicare.

Generally covers medically necessary equipment and services, such as illness treatment, preventative care, checkups, screenings, medical expenses in/out of hospital, including outpatient medical & surgical services, PT, diagnostic test

Medicare Part D (Prescription Drug Coverage Insurance)

Part D monthly premium

Most people will pay a monthly premium for this coverage. This coverage is to helps lower prescription drug costs and protects against higher costs in the future. Coverage is provided by private companies; you choose the drug plan and pay a monthly premium. If your income is above a certain limit, you’ll pay an income-related monthly adjustment amount in addition to your premium. This is collected by your plan. Like other insurance, if a beneficiary decides not to enroll in a drug plan when they are first eligible, they may pay a penalty if they choose to join later.

Medicare Enrollment & Timeline

Everyone’s situation is unique, call me today. Enrollment depends on your age, the time of year health condition, and work status, Medicare enrollment can be completed online by the Social Security Administration. In person at your local Social Security office or call Social Security at 1-800-772-1213. My service to you is to help with your specific timeline and assist with enrollment, whether you choose to work with me or not. You have to OPT into Medicare, unless you are already on social security prior to turning 65 or qualifying health event. Sign up for Medicare.

IEP-Medicare Initial Enrollment Period -7-month window. Three months before you turn 65, the month you turn 65, and three months after you turn 65.

AEP-Medicare Annual Enrollment Period- EVERY year Oct.15 -Dec.7. For those eligible for Medicare the following year, to make choices about their Medicare services for that year. This period is called Medicare Open Enrollment. Hence, there are a ton of commercials and junk mail. This is very similar to the open enrollment period used by most private health insurers.

SEP-Special Enrollment Period-Qualifying events. Generally, it takes two months from when your workplace coverage ends to sign up for Part D & eight months to sign up for Part B. Or there are penalties. COBRA is NOT considered creditable coverage.