Medicare Health Insurance

Get started with Medicare

Medicare is health insurance for people 65 or older. You may be eligible to get Medicare earlier if you have a disability, End-Stage Renal Disease (ESRD), or ALS (also called Lou Gehrig’s disease).

Some people get Medicare automatically, others have to actively sign up -- it depends if you start getting retirement or disability benefits from Social Security before you turn 65.

What do Social Security benefits have to do with getting Medicare?

Before you turn 65:

• If you apply to start getting retirement benefits from Social Security (or the Railroad Retirement Board) at least 4 months before you turn 65, you’ll automatically get Part A (Hospital Insurance) and Part B (Medical Insurance) when you turn 65.

• You’ll still need to make important decisions about how you get your coverage, including adding drug coverage.

If you want to get Medicare when you turn 65, but aren’t planning to take retirement benefits at that time, you’ll need to sign up for Medicare.

After you turn 65:

• You’ll have to contact Social Security when you’re ready to sign up for Medicare.

• Depending on your work situation and if you have health coverage through your employer, you may want to wait to sign up for Medicare.

Costs

What you pay for Medicare will vary based on what coverage and services you get, and what providers you visit. What are my coverage options?

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 can join a Medicare Advantage Plan.

Part A (Hospital Insurance) costs:

Part A 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 ($285 or $518 in 2025), depending on how long you or your spouse worked and paid Medicare taxes.

Remember:

• 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.
  

Deductible: $1,676 in 2025 for each inpatient hospital.
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.

Inpatient stay

• Days 1-60: $0 after you pay your Part A deductible.

• Days 61-90: $408 each day ($419 in 2025).

• Days 91-150: $816 each day ($838 in 2025) while using your 60

  lifetime reserve days

  .

• After day 150: You pay all costs.

Part B (Medical Insurance) costs

Premium: $185 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.

Deductible $257 in 2025 before Original Medicare starts to pay. You pay this deductible once each year.

General costs for services (coinsurance)Usually 20% of the cost for each Medicare-covered service or item after you’ve paid your deductible (and as long as your doctor or health care provider accepts the Medicare-approved amount as full payment – called “accepting assignment”).

Clinical laboratory services $0 for covered clinical laboratory services.

Home health care

• $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).
  

Inpatient hospital care 20% of theMedicare-approved amountfor most doctor services while you’re a hospital inpatient.

Outpatient hospital care

• Usually 20% of the Medicare-approved amount for doctor and other health care providers’ services.

• You’ll also pay a copayment to the hospital for each service you get in a hospital outpatient setting (except for certain preventive services). In most cases, your copayment won’t be more than the Part A hospital stay deductible amount.

  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.

Part D (Drug Coverage) costs

Premium:

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

Deductibles, copayments, & coinsuranceVaries by plan and pharmacy. Find Medicare drug plans in your area, and compare their costs and coverage.

Understand your Coverage Options

Explore Medicare health insurance options. Medicare Advantage, Medigap, and Part D for comprehensive coverage.

Advantage Plans

Discover Medicare Advantage plans that offer additional benefits beyond traditional Medicare coverage options.

Supplement Plans

Learn about Medicare supplement plans designed to cover costs not included in original Medicare.

Part D Coverage

Understand Part D plans for prescription drug coverage, ensuring you have access to necessary medications.

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We provide comprehensive information on Medicare health insurance, Medicare Advantage plans, Medicare supplement plans, and Part D to help you make informed decisions.

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