Each year, the Center for Medicare Services updates its Medicare premiums, deductibles, copays, and other numbers.
They do this to account for changes in administrative costs, health care costs, and the cost of living.
Likewise, private Medicare supplement (Medigap) and Medicare Advantage plans also update their numbers as well. This article provides all the latest information Medicare beneficiaries need to know for 2025.
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Overview of Medicare
Medicare consists of four basic parts:
- Part A: Hospital insurance
- Part B: Medical insurance for outpatient services, labs, and durable medical equipment
- Part C: Medicare Advantage plans (private plans combining Parts A, B, and often D)
- Part D: Prescription drug insurance
Below are the updated Medicare premiums, deductibles, and other costs for 2025.
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Medicare Part A (Hospital Insurance)
Key Costs for 2025
| Service | Beneficiary Cost |
|---|---|
| Part A Monthly Premium | $0 for most beneficiaries (if you or your spouse paid Medicare taxes for at least 10 years). Up to $518 per month if you don't qualify for premium-free Part A. |
| Inpatient Hospital Stay | Deductible: You pay $1,676 per benefit period. Days 1–60: You pay $0 per day after deductible. Days 61–90: You pay $419 per day. Lifetime Reserve Days (Days 91–150): You pay $838 per day (up to 60 days over your lifetime). Beyond 150 Days: You pay all costs. |
| Skilled Nursing Facility Stay | Days 1–20: $0 per day. Days 21–100: You pay $209.50 per day. Beyond 100 Days: You pay all costs. |
| Home Health Care | You pay $0 for covered home health care services. After your Part B deductible is met, you pay coinsurance of 20% of the Medicare-approved amount for durable medical equipment (like wheelchairs, walkers, hospital beds, and other equipment). |
| Hospice Care | You pay $0 for covered hospice care services. You pay a copayment of up to $5 for each prescription drug and other similar products for pain relief and symptom control while you're at home. You pay 5% of the Medicare-approved amount for inpatient respite care. |
Key Points to Remember:
- Benefit Period: Begins the day you’re admitted as an inpatient and ends when you haven’t received inpatient hospital or skilled nursing care for 60 days in a row.
- Lifetime Reserve Days: You have a total of 60 reserve days that can be used during your lifetime for hospital stays beyond 90 days.
- Skilled Nursing Facility Coverage: Requires a qualifying hospital stay of at least three days.
- Home Health Care and Hospice Services: Must be provided by a Medicare-approved provider.
Medicare Part B (Medical Insurance)
Key Costs for 2025
| Cost Component | Beneficiary Cost |
|---|---|
| Monthly Premium | - $185 for most beneficiaries. - Higher premiums apply if your modified adjusted gross income exceeds certain thresholds. - Individual Tax Return: More than $106,000. - Joint Tax Return: More than $212,000. - Married & Separate Tax Return: More than $106,000. - Income-related monthly adjustment amounts (IRMAA) apply for higher-income beneficiaries. |
| Annual Deductible | - $257 per year. - You must pay this amount before Medicare starts to pay its share for covered services. |
| Coinsurance for Services | - 20% of the Medicare-approved amount for most doctor services, outpatient therapy, and durable medical equipment after meeting the deductible. Medicare |
| Clinical Laboratory Services | - $0 for covered lab services. |
| Home Health Services | - $0 for covered home health care services. - 20% of the Medicare-approved amount for durable medical equipment. |
| Outpatient Mental Health Services | - $0 for annual depression screening. - 20% of the Medicare-approved amount for individual or group therapy. |
| Partial Hospitalization Mental Health Services | - 20% of the Medicare-approved amount for services provided in a hospital outpatient setting. |
| Insulin Costs | - $35 maximum for a one-month supply of Part B-covered insulin. - $105 maximum for a three-month supply. |
| Late Enrollment Penalty | - 10% increase in premiums for each full 12-month period you could have had Part B but didn't enroll. - This penalty is added to your monthly premium for as long as you have Part B. |
Key Points to Remember:
- Income-Related Monthly Adjustment Amount (IRMAA): Higher-income beneficiaries pay additional amounts on top of the standard premium.
- Annual Deductible: You must pay the annual deductible before Medicare covers its share of most Part B services.
- Coinsurance: After meeting the deductible, you’re typically responsible for 20% of the Medicare-approved amount for most services.
- Preventive Services: Many preventive services, such as annual wellness visits and certain screenings, are covered at 100%, meaning you pay nothing out-of-pocket.
- Late Enrollment Penalty: To avoid the penalty, ensure you enroll in Part B when first eligible unless you have other credible coverage.
- Original Medicare does not include prescription drug insurance. For that, you must enroll in a Medicare Part D plan, or purchase a Medicare Advantage Plan that includes prescription drug coverage.
- Higher-income households may pay higher Part B premiums. See our section on IRMAA, below.
Medicare Part C (Medicare Advantage)
Key Costs for 2025
| Cost Component | Details |
|---|---|
| Monthly Premium | Premiums: Many Medicare Advantage plans have a $0 premium, while others charge a monthly premium in addition to the Part B premium. In 2025, the average monthly premium for Medicare Advantage is $17. Note: You must continue to pay your Part B premium, which is $185 in 2025. |
| Deductibles | Medical Deductible: Some plans may have a deductible for medical services; others may not. Varies by plan. Drug Deductible: If the plan includes Part D coverage, there may be a separate deductible for prescription drugs. |
| Copayments/Coinsurance | Varies by service: Copayments (a fixed amount) or coinsurance (a percentage of the cost) are required for services like doctor visits, specialist consultations, hospital stays, and prescription drugs. Example: A primary care visit might have a $20 copayment, while a specialist visit could have a $50 copayment. |
| Maximum Out-of-Pocket Limit | Annual Limit: The maximum out-of-pocket limit (MOOP) for covered services in 2025 $9,350. However, more than 95% of plans have a lower MOOP. Average Limit: In 2025, the median MOOP limit for Medicare Advantage plans is $5,400. Note: Once you reach your MOOP limit, the plan pays 100% for covered services for the rest of the year. |
| Additional Benefits | Included Services: Many plans offer extra benefits like dental, vision, hearing, and fitness programs. Costs: These benefits may come with additional costs or may be included in the plan's premium. |
Key Considerations:
- Plan Variability: Costs and coverage details can vary significantly between plans and locations. It’s essential to review each plan’s specifics to understand your potential expenses.
- Annual Plan Changes: Medicare Advantage plans can change their premiums, deductibles, copayments, and coverage annually. Reviewing your plan during the Annual Enrollment Period (October 15 – December 7) is crucial to ensure it still meets your needs.
- Provider Networks: These plans often have specific networks of doctors and hospitals. Using out-of-network providers can result in higher costs or may not be covered.
- Prescription Drug Coverage: Not all Medicare Advantage plans include Part D coverage. If you require prescription drug coverage, ensure the plan you choose includes it.
For personalized assistance in selecting a Medicare Advantage plan that fits your healthcare needs and budget, contact a MediGap Advisors Personal Benefits Manager. They can provide expert guidance tailored to your situation.
Medicare Part D (Prescription Drug Insurance)
Medicare prescription drug coverage underwent significant changes in 2025.
The Medicare Part D “coverage gap” essentially went away, for example, and the total out-of-pocket cost cap for Medicare coverage was reduced substantially, from $8,000 per year to just $2,000 per year in 2025.
Additionally, the Center for Medicare Services rolled out the new Prescription Drug Payment Plan. This allows Part D beneficiaries to spread out their prescription drug costs over time, rather than pay their entire out-of-pocket cost upfront.
Key Costs for 2025
| Cost Component | Beneficiary Cost in 2025 |
|---|---|
| Monthly Premium | Varies by plan: Each Medicare Part D plan sets its own premium. Average Premium: The national average monthly premium is projected to be $36.78. Income-Related Monthly Adjustment Amount (IRMAA): Higher-income beneficiaries may pay an additional amount on top of their plan premium. |
| Annual Deductible | Deductible: Plans may charge a deductible up to $590. Some plans may have lower deductibles or none at all. |
| Copayments/Coinsurance | Varies by plan and drug tier: After meeting the deductible, you'll pay a copayment (a fixed amount) or coinsurance (a percentage of the drug cost) for each prescription. Example: Generic drugs may have lower copayments, while brand-name or specialty drugs may have higher coinsurance rates. |
| Coverage Gap ("Donut Hole") | Eliminated: The coverage gap has been closed, meaning you continue to pay your plan's designated copayments or coinsurance until reaching the out-of-pocket maximum. |
| Out-of-Pocket Maximum | Annual Cap: Starting in 2025, your yearly out-of-pocket drug costs are capped at $2,000. Once you reach this limit, you won't pay any more for covered Part D drugs for the rest of the year. |
| Late Enrollment Penalty | Applies if: You don't join a Medicare drug plan when first eligible and go 63 days or more without other creditable prescription drug coverage. Calculation: 1% of the national base beneficiary premium ($36.78 in 2025) multiplied by the number of full, uncovered months you were eligible but didn't enroll. Example: If you were without coverage for 14 months, your monthly penalty would be approximately $5.20 (1% × $36.78 × 14), added to your plan premium. |
Key Considerations:
- Plan Variability: Costs can vary significantly between plans. It’s essential to compare options during the Annual Enrollment Period (October 15 – December 7) to find coverage that best fits your needs.
- Formulary Differences: Each plan has a formulary (list of covered drugs). Ensure your medications are included to avoid higher out-of-pocket expenses.
- Pharmacy Networks: Using in-network pharmacies can lower your costs. Some plans offer preferred pharmacies with even greater savings.
- Extra Help Program: If you have limited income and resources, you may qualify for Extra Help to pay for your Part D costs, including premiums, deductibles, and copayments.
- Certain higher-income households may pay higher premiums for Part D coverage. See our section on IRMAA, below.
For personalized assistance in selecting a Medicare Part D plan that aligns with your healthcare needs and budget, consider contacting a MediGap Advisors Personal Benefits Manager. They can provide expert guidance tailored to your situation.
Medi-Share 65+: A Medicare Supplement Alternative
Medi-Share 65+ is a powerful and affordable non-insurance alternative to the more well-known Medicare supplement insurance (Medigap) plans.
It is a health sharing plan, rather than a traditional insurance product like a Medigap plan. However, it serves the same purpose: Protect members against the many out-of-pocket costs that Medicare Part A and Part B approve but don’t pay.
Specifically, Medi-Share 65+ steps in to pay Medicare deductibles, co-insurance costs, and co-pays under Parts A and B (Original Medicare).
Key Costs and Features for 2025
| Cost Component | Out-of-Pocket Costs to Members |
|---|---|
| Monthly Cost | Age 65 to 74: $99 per month Age 75 and up: $150 per month |
| Member Responsibility Amount | Similar concept to health insurance deductible Member pays first $500 per year for services covered but not paid by Medicare Parts A and B Calculated per household, not per individual |
| Pre-Existing Conditions | A 6-month waiting period applies to pre-existing conditions Waiting period waived if you sign up during your initial Medicare eligibility period, or during the Fall Open Enrollment period (15 October - 7 December) |
| Prescription Drug Benefits | Discount plan available through Medi-Share, but no direct drug insurance coverage Consider purchasing a Part D plan to go along with Medi-Share 65+ |
| Can you see any doctor? | Yes. No limited care networks for Medi-Share 65+ or Medigap plans. |
| Exclusions | Does not share costs for inpatient drug or alcohol rehab programs. Members must affirm they do not abuse alcohol or drugs at sign-up. Does not share costs arising from suicide attempts, self-harm, or criminal activity. Limited mental health benefits Does not share costs arising from DWI incidents, even if only as a passenger |
Note: Medi-Share is an explicitly Christian health sharing ministry. Members must confirm belief in the divinity of Christ and the Trinity. They must also agree that they will live according to the principles of the Christian faith.
Price Lock-In: Currently, Medi-Share 65+ offers a price lock-in guarantee: New members will not face a monthly contribution increase until age 75. That means up to 10 years of guaranteed level pricing.
Medicare Supplement Insurance (Medigap)
Medicare Supplement Insurance, commonly known as Medigap, helps cover certain out-of-pocket costs not paid by Original Medicare, such as copayments, coinsurance, and deductibles.
These plans are standardized and labeled with letters (e.g., Plan A, Plan B, Plan G), with each offering a different combination of benefits.
Medigap plans only underwent a few changes for 2025. Notably, the deductible for the High Deductible Plan G was increased to $2,870. Also, the out-of-pocket limits for Plans K and L also went up, to $7,220 and $3,610, respectively.
Some plan premiums went up, but that is specific to the individual plan. If you’re currently enrolled in a Medigap plan, you should have received a letter in September detailing any price increases or changes in your coverage.
Here is the updated 2025 table of Medigap plans and coverage:
Medicare Supplement Insurance Plans and Benefits Table, 2025
| Medigap Benefit | Plan A | Plan B | Plan C | Plan D | Plan F | Plan G | Plan K | Plan L | Plan M | Plan N |
|---|---|---|---|---|---|---|---|---|---|---|
| Part A Coinsurance and Hospital Costs | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ |
| Part B Coinsurance or Copayment | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ | 50% | 75% | ✔ | ✔* |
| First 3 Pints of Blood | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ | 50% | 75% | ✔ | ✔ |
| Part A Hospice Care Coinsurance or Copayment | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ | 50% | 75% | ✔ | ✔ |
| Skilled Nursing Facility Care Coinsurance | ✔ | ✔ | ✔ | ✔ | 50% | 75% | ✔ | |||
| Part A Deductible | ✔ | ✔ | ✔ | ✔ | ✔ | 50% | 75% | 50% | ✔ | |
| Part B Deductible | ✔ | ✔ | ||||||||
| Part B Excess Charges | ✔ | ✔ | ||||||||
| Foreign Travel Emergency (Up to Plan Limits) | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ | ||||
| Out-of-Pocket Limit | N/A | N/A | N/A | N/A | N/A | N/A | $7,220** | $3,610** | N/A | N/A |
2025 IRMAA Adjustments for High-Income Households
Certain higher-income households may have to pay more for Medicare Part B and D coverage.
Your 2025 premiums will be based on your 2023 income. If you meet these income thresholds, your base premiums for Medicare Parts B and D will be increased as follows:
| 2023 Income (Single) | 2023 Income (Married Filing Jointly) | Part B Income-Related Monthly Adjustment Amount | Part D Income-Related Monthly Adjustment Amount |
|---|---|---|---|
| Less than or equal to $106,000 | Less than or equal to $212,000 | $185.00 | $0.00 |
| Greater than $ 106,000and less than $133,000 | Greater than $212,000 and less than $266,00 | $259.00 | $13.70 |
| Greater than $133,000 and less than $167,000 | Greater than $266,000 and less than $334,000 | $370.00 | $35.30 |
| Greater than $167,000 and less than $200,000 | Greater than $ 334,000 and less than $400,000 | $480.90 | $57.00 |
| Greater than $200,000 and less than $500,000 | Greater than $400,000 and less than $750,000 | $591.90 | $78.60 |
| Greater than or equal to $500,000 | Greater than or equal to $750,000 | $628.90 | $85.80 |
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Conclusion
Understanding Medicare premiums and Medicare costs can feel overwhelming, but it doesn’t have to be.
At MediGap Advisors, our team of Medicare and insurance experts can help you simplify the decision-making process. We can help you keep track of the changes, and help you enroll in the right plan for your individual needs.
And there’s no charge for our services. Consultations are always free. And can save you hours of research and stress.
All you need to do is make an appointment with a MediGap Advisors Personal Benefits Manager. We’ll go over your situation, review the plans available, and help you select the course of action that makes the most sense for you.
For Further Reading:
Christine Corsini is one of your Personal Benefits Managers at MediGap Advisors. She loves working for Medigap Advisors especially helping clients choose the right Medicare plan.