Medicare Part A & Part B

Original Medicare contains Part A and Part B. Below is what you would be responsible for if you had only Part A & Part B.

Part A is Hospital Insurance

Part A is designed to cover costs associated with inpatient Medical treatment including hospital inpatient care, care at a skilled nursing facility, hospice, and home health care.

Inpatient Hospital Deductible for 2025

• $1,676 deductible for each benefit period (60 day benefit period)
• Days 1 – 60 = $0 copay after deductible
• Days 61 – 90 = $419 copay per day
• Days 91 and beyond = $838 copay per each “lifetime reserve day” after 90 each benefit period
  • There are up to 60 lifetime reserve days in your lifetime.

Skilled Nursing Facility for 2025

• Days 1 – 20 = $0 copay
• Days 21 – 100 = $209.50 copay per day
  • Note: Medicare only pays for a Skilled Nursing Facility if you have had experienced an inpatient hospitalization stay for at least 3 consecutive days prior.
• After day 100 you are responsible for all charges

Hospice Care for 2025 has $0 copay

Home Health Care for 2025 has $0 copay

• Note: Medicare does not cover 24 hour care at home or custodial care, which is help with activities of daily living.

Is there a cost to have Part A?

No charge to simply carry Part A if you paid into Medicare or married to someone who has paid Medicare taxes while working.

Part B is Medical Insurance

Part B is designed to help cover costs of outpatient medical services. There are many services covered by Part B. Below are common items.

Part B covered services include (but not limited to):

• Doctor office visits
• Outpatient surgeries
• Outpatient therapy (physical therapy, occupational therapy, and more)
• Durable medical equipment

Annual Deductible for 2025 = $257

Medical & Other Services you pay 20% of the Medicare-approved amount.

Premiums for Part B:

In 2025, the base premium to carry Part B is $185.00 monthly per individual.

• Depending on your income limit, there may be assistance available to help pay the Part B premium.
• You may pay more due to what is known as the income-related monthly adjustment amount (IRMAA). Your IRMAA surcharge is based on your modified adjusted gross income reported on your federal tax return from two years ago. See chart below.
  • If you have a qualifying life changing event and your income is currently lower than the reporting from 2 years ago, you can appeal the surcharge.

Is there a maximum out-of-pocket limit with Original Medicare?

There is no limit to how much medical bills can add to over a calendar year with Original Medicare- it is smart to choose a Medicare Supplement or a Medicare Advantage Plan.