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Medicare Costs

Let’s Break Down the Costs of Medicare Part A and B

Doctor Costs
Medicare Costs

Let’s Break Down the Costs of Medicare Part A and Part B

Medicare costs can feel confusing because premiums, deductibles, coinsurance, hospital stays, skilled nursing care, and outpatient services all work differently. This guide organizes the major Original Medicare costs in a cleaner, easier-to-follow format.

Use the Medicare Quoting Tool View Part A and B Costs
Part A Premium $0 For most people who worked and paid Medicare taxes long enough.
Part A Deductible $1,736 Per inpatient hospital benefit period.
Part B Premium $202.90 Monthly standard premium, higher for some income levels.
Part A

Hospital Insurance Costs

Medicare Part A generally helps cover inpatient hospital care, skilled nursing facility care, hospice care, and some home health care services.

Part A Premiums

$0 for most people

Most people do not pay a Part A premium because they or a spouse paid Medicare taxes long enough while working, generally at least 10 years.

If you do not qualify for premium-free Part A, you may be able to buy it. The monthly premium may be either $311 or $565 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. If you do not buy Part A when first eligible, you may pay a penalty.

Part A Deductible

$1,736 per benefit period

You pay the Part A deductible before Original Medicare starts to pay for an inpatient hospital stay.

There is no limit to the number of benefit periods you can have in a year, which means you may pay this deductible more than once in a year.

Inpatient Hospital Stay

  • Days 1 to 60: $0 after you pay your Part A deductible.
  • Days 61 to 90: $434 each day.
  • Days 91 to 150: $868 each day while using your 60 lifetime reserve days.
  • After day 150: You pay all costs.

Skilled Nursing Facility Stay

  • Days 1 to 20: $0.
  • Days 21 to 100: $217 each day.
  • Days 101 and beyond: You pay all costs.

Home Health Care

  • Covered home health care services: $0.
  • Durable medical equipment: 20% of the Medicare-approved amount.

Hospice Care

$0 for covered hospice care services

You may also pay certain small costs related to hospice care.

  • Up to a $5 copayment for each prescription drug and similar products for pain relief and symptom control while at home.
  • 5% of the Medicare-approved amount for inpatient respite care.
Part B

Medical Insurance Costs

Medicare Part B generally helps cover doctor services, outpatient care, preventive services, mental health care, lab services, and certain medically necessary supplies.

Part B Premiums

$202.90 each month

The standard Part B premium is paid each month, even if you do not receive any Part B-covered services. The amount can be higher depending on your income.

You may pay a monthly penalty if you do not sign up for Part B when first eligible. The penalty can last as long as you have Part B.

Part B Deductible

$283 per year

You pay this deductible once each year before Original Medicare starts to pay for most Part B services.

General Cost for Services

Clinical Laboratory Services

Costs can vary depending on the service. Your current page content listed skilled nursing day ranges under this section, so this section should be reviewed before publishing.

Recommended fix: confirm the exact lab service cost language before making this page public.

Home Health Care

  • Covered home health care services: $0.
  • Durable medical equipment: 20% of the Medicare-approved amount.

Inpatient Hospital Care

You generally pay 20% of the Medicare-approved amount for most doctor services while you are a hospital inpatient.

Outpatient Mental Health Care

  • Yearly depression screening: $0.
  • Doctor or provider visits: 20% of the Medicare-approved amount to diagnose or treat your condition.
  • You may pay an additional hospital amount if services are received in a hospital outpatient clinic or department.

Partial Hospitalization Mental Health Care

After you meet the Part B deductible, you may pay:

  • 20% of the Medicare-approved amount for each service from a doctor or certain qualified mental health professional.
  • Coinsurance for each day of partial hospitalization services in a hospital outpatient setting or community mental health center.

Outpatient Hospital Care

You usually pay 20% of the Medicare-approved amount for doctor and other health care provider services.

You may also pay a copayment to the hospital for each service received in a hospital outpatient setting, except for certain preventive services. In most cases, your copayment will not be more than the Part A hospital stay deductible amount.

This additional hospital copayment can mean you pay more for an outpatient service in a hospital than you would pay for the same service in a doctor’s office.

Need Help Comparing Medicare Options?

Original Medicare is only one part of the decision. Medicare Advantage, Medicare Supplements, and Part D prescription drug plans can all affect your total costs and coverage.

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Senior Healthcare Planning is an independent insurance agency that provides education, guidance, and enrollment assistance for Medicare-related insurance products, including Medicare Advantage, Medicare Supplement, and Prescription Drug Plans. Senior Healthcare Planning is not connected with or endorsed by the United States government or the federal Medicare program.

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