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Does Medicare cover all my health care costs?

No. Even though Medicare can cover many of your health care costs, you’ll still have some out-of-pocket expenses, including premiums, deductibles, copayments and coinsurance.

Though original Medicare doesn’t pay for some of the care you need, such as most dental, hearing and vision services, it does offer almost universal coverage to adults 65 and older. Fewer than 1 percent were uninsured in 2021 versus more than half before Medicare started paying benefits in 1966. Yet for 1 in 5 adults of Medicare age, out-of-pocket health care costs in 2021 exceeded $2,000, according to a survey from the Commonwealth Fund.

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Here’s a breakdown of Medicare-covered expenses by each part or plan and what you may need to pay yourself.

What are the costs for Medicare Part A?

Premium. Most people don’t pay premiums for Medicare Part A, which covers inpatient stays in hospitals and skilled nursing facilities, some home health services and end-of-life hospice care. You don’t have to pay Part A premiums if you or your spouse had Medicare taxes deducted from your paychecks for at least 40 quarters of work, the equivalent of 10 years or more. The quarters don’t have to be consecutive.

If you don’t qualify for premium-free Part A, you can choose not to buy it. But if you do have to pay, you’ll also need to pay for Part B. Part A premiums are:

  • $278 a month in 2023 and 2024 if you or your spouse paid 30 to 39 quarters of Medicare taxes.
  • $506 a month in 2023 if you or your spouse paid fewer than 30 quarters of Medicare taxes, dropping to $505 in 2024.

Deductible. You must pay a $1,600 Part A deductible for each benefit period you’re hospitalized in 2023, which rises to $1,632 in 2024. A benefit period begins when you’re admitted to a hospital or skilled nursing facility as an inpatient and ends when you’ve been out of the hospital or facility for 60 days in a row.

Coinsurance. You may have to pay a portion of the costs, called coinsurance, if you stay in a hospital or skilled nursing facility for a long time. Medicare covers your first 60 days as a hospital inpatient, but in 2023, you pay $400 a day for days 61 to 90 and $800 a day for up to 60 lifetime reserve days. Those amounts rise to $408 and $816 in 2024.

Each lifetime reserve day can be used only once but can apply to different benefit periods. You pay all costs beyond 90 days per benefit period if you use up your lifetime reserve days.

If you have a qualifying stay in a skilled nursing facility, Medicare can cover the first 20 days. But you’ll have to pay coinsurance for days 21 to 100, at $200 a day in 2023; $204 in 2024 and all costs beyond day 100.

If you’re receiving end-of-life care through a hospice program, you may have to pay up to $5 per prescription for pain and symptom management and 5 percent of the Medicare-approved amount for respite care.

What are the costs for Part B?

Medicare Part B helps pay for doctor visits, diagnostic screenings, lab tests, preventive care, medical equipment, transportation and other outpatient services.

Premiums. Most people pay $164.90 a month in 2023 for Medicare Part B premiums or $174.70 in 2024. People who are single with an adjusted gross income of more than $97,000, or married filing jointly with income greater than $194,000, pay a high-income surcharge with premiums ranging from $230.80 to $560.50 a month in 2023, depending on income level.


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The income level and surcharges rise in 2024. Single filers with income above $103,000 and joint filers earning more than $206,000 pay a premium that ranges from $244.60 to $594.00. The surcharge is based on their last tax return on file, which is generally 2022 for 2024 premiums.

If you don’t enroll in Medicare when you are first eligible or qualify for a special enrollment period to sign up later, you may have to pay a late enrollment penalty, which is added to your Part B premiums for as long as you have the coverage.

Deductible. You’ll have to pay $226 in 2023 before most Part B coverage begins; that number increases to $240 in 2024.

Coinsurance. After paying the deductible, you generally pay 20 percent of the Medicare-approved amount, called coinsurance, for most doctor and outpatient services and for durable medical equipment. Part B covers some preventive services without a deductible or coinsurance.

What are the costs for Part C, Medicare Advantage?

Premiums. If you decide to get your Medicare coverage through a private Medicare Advantage plan instead of original Medicare, you still must pay the monthly premiums for Part B — and Part A if you don’t qualify for premium-free Part A. Some Medicare Advantage plans also charge an average of $18.50 a month, although two-thirds of the plans have no additional premium.

Deductibles and copayments. Medicare Advantage plans must provide at least as much coverage as original Medicare, but the deductibles and copayments can be different and vary by plan. All Medicare Advantage plans have an annual cap on out-of-pocket expenses for services covered under Part A and Part B.

The out-of-pocket limit for Part C plans in 2023 is $8,300 or less for in-network health services and $12,450 or less for in-network and out-of-network services combined. Those limits rise to $8,850 and $13,300 in 2024. Some plans have lower spending ceilings.

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What are the costs for a Part D prescription drug plan?

Premiums. Medicare doesn’t automatically cover prescription drugs, but you can buy a Part D plan from a private insurer. These plans charge a monthly premium that varies by plan, averaging $55.50 in 2024.

People with higher incomes pay a surcharge that adds $12.20 to $76.40 to their monthly bills in 2023, and $12.90 to $81 in 2024. If you don’t sign up for a Part D plan when you’re first eligible and don’t have other similar drug coverage, you may have to pay a late enrollment penalty.

Deductible, copayments, coinsurance. Part D plans can have a deductible of up to $505 in 2023 and $545 in 2024. You’ll also have copayments or coinsurance for your drugs, based on the plan, the medication and how much you’ve spent so far on prescriptions during the year.

In 2024, you reach the coverage gap — where you have to pay up to 25 percent of the cost of covered drugs — when you and your insurer have paid $5,030 in drug costs for the year. You reach the catastrophic phase after you’ve spent $8,000 from your own pocket and, because of a change in law, you don’t have to pay anything for covered prescription drugs for the rest of the year.

Keep in mind

If you have original Medicare, you may be able to cover many of the out-of-pocket costs for Part A and Part B by buying a Medicare supplemental policy, better known as Medigap, from a private insurer.

But you’ll pay for expenses that Medicare doesn’t cover, such as most dental, hearing and vision care.

If you choose a Medicare Advantage plan instead of original Medicare, the plan may have different copayments and deductibles than Medicare, and its network of doctors and other health care providers usually is limited. But the plan may include some benefits not part of original Medicare, such as dental, hearing and vision care. These benefits come with their own deductibles and copays.

Financial assistance is available at both the federal and state levels for those who can’t afford all the costs associated with Medicare.

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