2. Medicare Part B (Medical Insurance) Costs

Medicare Part B covers essential medical services, including physician visits, outpatient hospital services, durable medical equipment, and various other health services not covered by Medicare Part A. In 2025, there are significant changes to Part B premiums and deductibles:

Premium Increase: The standard monthly premium for Medicare Part B enrollees will be $185.00 in 2025, a $10.30 increase from $174.70 in 2024. This increase is primarily due to projected price changes and assumed utilization increases consistent with historical experience.                                                             

The premium amount can be higher depending on your income. You’ll pay this premium each month, even if you don’t receive any Part B-covered services.

Deductible Increase: The annual deductible for all Medicare Part B beneficiaries will be $257 in 2025, up from $240 in 2024, an increase of $17. This deductible is paid once each year before Original Medicare starts to cover your services

General Costs for Services (Coinsurance): After meeting the Part B deductible, you typically pay 20% of the Medicare-approved amount for each service or item. This applies as long as your doctor or healthcare provider accepts the Medicare-approved amount as full payment.

• Clinical Laboratory Services: $0 for covered clinical laboratory services.

• Durable Medical Equipment: 20% of the Medicare-approved amount for items like wheelchairs, walkers, hospital beds, and other equipment.

• Inpatient Hospital Care: 20% of the Medicare-approved amount for most doctor services while you’re a hospital inpatient.

• Outpatient Mental Health Care:

  • $0 for your yearly depression screening.
  • 20% of the Medicare-approved amount for visits to your doctor or other healthcare provider to diagnose or treat your condition.
  • If you receive services in a hospital outpatient clinic or department, you may have to pay an additional amount to the hospital.

• Partial Hospitalization Mental Health Care: After meeting the Part B deductible, you pay:

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

• Outpatient Hospital Care: Usually 20% of the Medicare-approved amount for doctor and other healthcare providers’ services. You may also pay a copayment to the hospital for each service received in a hospital outpatient setting.

Income-Related Monthly Adjustment Amounts (IRMAA): Beneficiaries with higher incomes pay an additional amount, known as IRMAA, on top of the standard Part B premium. The 2025 Part B total premiums for high-income beneficiaries with full Part B coverage are as follows:

Income-Related Monthly Adjustment Amounts for Married Beneficiaries Who File Separate Tax Returns (Full Part B Coverage):

These adjustments are based on your reported income and are designed to ensure that higher-income beneficiaries contribute more to the Medicare program.

3. Medicare Advantage Plan (Part C) Costs

Medicare Advantage Plans offer an alternative to Original Medicare. Costs can vary depending on the specific plan you choose. It’s important to have Part B and continue paying your Part B premium to stay in your Medicare Advantage Plan.

• Premiums & Other Costs: Varies by plan, including deductibles, copayments, and coinsurance. These amounts can change each year.

• Out-of-Pocket Limit: Varies by plan. Once you reach the plan’s limit, the plan pays 100% of your covered health services for the rest of the calendar year.

4. Medicare Part D (Drug Coverage) Costs

Medicare Part D provides coverage for prescription drugs. Costs can vary depending on the specific Part D plan you choose.

• Premium: Varies by plan, and it may be higher based on your income. You can avoid paying a penalty by joining a Medicare drug plan when you first get Medicare Part A and/or Part B and ensuring you don’t go 63 days or more without creditable drug coverage.

• Deductibles, Copayments, & Coinsurance: These costs vary by plan and pharmacy. You can find Medicare drug plans in your area and compare their costs and coverage.

Since 2011, a beneficiary’s Part D monthly premium has been based on their income. These income-related monthly adjustment amounts impact about 8% of people with Medicare Part D. These individuals will pay the income-related monthly adjustment amount in addition to their Part D premium. Here are the 2025 Part D income-related monthly adjustment amounts for high-income beneficiaries:

Income-Related Monthly Adjustment Amounts for Beneficiaries who file individual tax returns and joint tax returns with modified adjusted gross income:

For Married Individuals Filing Separately:

Part D Extra Help

If you’re seeking assistance with prescription drug costs, the Medicare Part D Low-Income Subsidy (LIS), also known as “Extra Help,” may be available to you. Eligibility for this program in 2025 is based on your income and resources:

Income Limits:

• Individual: Annual income up to $22,590.
• Married Couple (living together): Annual income up to $30,660.

Resource Limits:

• Individual: Resources not exceeding $17,220.
• Married Couple (living together): Resources not exceeding $34,360.

Resources include assets such as bank accounts, stocks, and bonds, but exclude your primary residence, personal possessions, and vehicles. It’s important to note that certain types of income and resources may not be counted, so even if your income or resources are slightly above these limits, you may still qualify.

To apply for Extra Help, you can visit the Social Security Administration’s website or call 1-800-772-1213. TTY users can call 1-800-325-0778. Applying for this program can significantly reduce your prescription drug costs, making your medications more affordable.

Part D Late Enrollment Penalty