Medicare costs at a glance

Medicare monthly premiums

  • Part A (Hospital Insurance) monthly premium (for people who pay a premium): If you buy Part A, you'll pay up to $451 each month. Higher-income consumers may pay more.
  • Part A late enrollment penalty: If you don't buy it when you're first eligible, your monthly premium may go up 10%. (You'll have to pay the higher premium for twice the number of years you could have had Part A, but didn't sign up.)
  • Part B (Medical Insurance) monthly premium: Most people pay the Part B premium of $99.90 each month. 
  • Part B late enrollment penalty: If you don't sign up for Part B when you're first eligible, you may have to pay a late enrollment penalty for as long as you have Medicare. Your monthly premium for Part B may go up 10% for each full 12-month period that you could have had Part B, but didn't sign up for it.
  • Part C (Medicare Advantage) monthly premium: The Part C monthly premium varies by plan.
  • Part D (Medicare prescription drug coverage) monthly premium: The Part D monthly premium varies by plan (higher-income consumers may pay more). 
  • Part D late enrollment penalty: The cost of the late enrollment penalty depends on how long you went without creditable prescription drug coverage.  

What you pay if you have Original Medicare

Medicare Part A (Hospital Insurance) costs

Blood

In most cases, the hospital gets blood from a blood bank at no charge, and you won't have to pay for it or replace it. If the hospital has to buy blood for you, you must either pay the hospital costs for the first 3 units of blood you get in a calendar year or have the blood donated.

Home health care

  • $0 for home health care services.
  • 20% of the Medicare-approved amount for durable medical equipment.

Hospice care

  • $0 for hospice care and there is no deductible.
  • Copayment of up to $5 per prescription for outpatient prescription drugs for pain and symptom management.
  • 5% of the Medicare-approved amount for inpatient respite care (short-term care given by another caregiver, so the usual caregiver can rest).
  • Your usual Part B deductible and coinsurance for your doctor’s services (if your attending doctor isn't employed by the hospice).
  • Medicare doesn't cover room and board when you get hospice care in your home or another facility where you live (like a nursing home).
  • If you pay out-of-pocket for an item or service your doctor ordered, but the hospice refuses to give you, you can file a claim with Medicare. If your claim is denied, you may file an appeal.

Hospital inpatient stay

You pay:

  • Days 1–60: $1,156 deductible for each benefit period.
  • Days 61–90: $289 coinsurance per day of each benefit period.
  • Days 91 and beyond: $578 coinsurance per each "lifetime reserve day" after day 90 for each benefit period (up to 60 days over your lifetime).
  • Beyond lifetime reserve days: all costs.
Note

You pay for private-duty nursing, a television, or a phone in your room. You pay for a private room unless it's medically necessary.

Mental health inpatient stay

You pay:

  • Days 1–60: $1,156 deductible for each benefit period.
  • Days 61–90: $289 coinsurance per day of each benefit period.
  • Days 91 and beyond: $578 coinsurance per each "lifetime reserve day" after day 90 for each benefit period (up to 60 days over your lifetime).
  • Beyond lifetime reserve days: all costs.
Note

There's no limit to the number of benefit periods you can have when you get mental health care in a general hospital. You can also have multiple benefit periods when you get care in a psychiatric hospital. Remember, there's a lifetime limit of 190 days.

  • 20% of the Medicare-approved amount for mental health services you get from doctors and other providers while you're a hospital inpatient.

Skilled nursing facility stay

  • $0 for the first 20 days each benefit period.
  • $144.50 per day for days 21-100 each benefit period.
  • All costs for each day after day 100 in a benefit period.
Note

If you're in a Medicare Advantage Plan, costs vary by plan and may be either higher or lower than those noted above. Review the "Evidence of Coverage" from your plan.

Medicare Part B (Medical Insurance) costs

Part B monthly premium

You pay a Medicare Part B (Medical Insurance) premium each month. Most people will pay the standard premium amount. However, if your modified adjusted gross income as reported on your IRS tax return from 2 years ago is above a certain amount, you may pay more.

If your yearly income in 2010 wasYou pay
File individual tax returnFile joint tax return
$85,000 or less$170,000 or less$99.90
above $85,000 up to $107,000above $170,000 up to $214,000$139.90
above $107,000 up to $160,000above $214,000 up to $320,000$199.80
above $160,000 up to $214,000above $320,000 up to $428,000$259.70

To get more information about your Part B premium, contact Social Security.

Blood

If the provider gets blood from a blood bank at no charge, you won’t have to pay for it or replace it. However, you’ll pay a copayment for the blood processing and handling services for every unit of blood you get, and the Part B deductible applies. If the provider has to buy blood for you, you must either pay the provider costs for the first 3 units of blood you get in a calendar year or have the blood donated by you or someone else.

Clinical laboratory services

You pay $0 for Medicare-approved services.

Home health services

You pay: 

  • $0 for home health care services.
  • 20% of the Medicare-approved amount for durable medical equipment.

Medical and other services

You pay 20% of the Medicare-approved amount for most doctor services (including most doctor services while you're a hospital inpatient), outpatient therapy, and durable medical equipment.

Outpatient mental health services

You pay:

  • 20% of the Medicare-approved amount for visits to a doctor or other health care provider to diagnose your condition or to monitor or change your prescriptions.
  • 40% of the Medicare-approved amount for outpatient treatment of your condition (such as counseling or psychotherapy) in a doctor's office setting. In a hospital outpatient setting, you pay a copayment.

Partial hospitalization mental health services

You pay:

  • 40% of the Medicare-approved amount for each service you get from a qualified professional, and
  • 20% of the Medicare-approved amount for each day of service you get in a hospital outpatient department or a community mental health center.

Other covered services

You pay copayment or coinsurance amounts.

Note

In 2012, there may be limits on physical therapy, occupational therapy, and speech language pathology services. If so, there may be exceptions to these limits. 

All Medicare Advantage Plans must cover these services. If you're in a Medicare Advantage Plan, costs vary by plan and may be either higher or lower than those noted above. Review the "Evidence of Coverage" from your plan.

Outpatient hospital services 

  • You generally pay 20% of the Medicare-approved amount for the doctor's services.
  • For all other services, you pay a copayment for each service you get in an outpatient hospital setting.
  • For some screenings and preventive services, these charges and the Part B deductible don't apply.

Medicare prescription drug coverage (Part D) costs

Part D monthly premium

The chart below shows your estimated prescription drug plan monthly premium based on your income. If your income is above a certain limit, you'll pay an income-related monthly adjustment amount in addition to your plan premium.

If your yearly income in 2010 wasYou pay
File individual tax returnFile joint tax return
$85,000 or less$170,000 or lessYour plan premium
above $85,000 up to $107,000above $170,000 up to $214,000$11.60 + your plan premium
above $107,000 up to $160,000above $214,000 up to $320,000$29.90 + your plan premium
above $160,000 up to $214,000above $320,000 up to $428,000$48.10+ your plan premium
above $214,000above $428,000$66.40 + your plan premium