What you pay for Medicare will vary based on what coverage and services you get, and what providers you visit. What are my coverage options?

There’s no yearly limit on what you pay out-of-pocket, unless you have supplemental coverage, like a Medicare Supplement Insurance (Medigap) policy, or you join a  Medicare Advantage Plan.

Part A costs: What you pay in 2024:
Premium $0 for most people (because they or a spouse paid Medicare taxes long enough while working – generally at least 10 years). If you get Medicare earlier than age 65, you won’t pay a Part A premium. This is sometimes called “premium-free Part A.”

Who qualifies for Part A without paying a monthly premium?

You usually don’t pay a monthly premium for Part A if you (or another qualifying person, like your current or former spouse) paid Medicare taxes while working for a certain amount of time. (If you’re 65 or older, usually this is 10 years of work. If you get Medicare earlier than age 65, you won’t pay a Part A premium.)

If you qualify, you can sign up for Part A coverage starting 3 months before you turn 65 and any time after you turn 65.
Part A coverage starts up to 6 months back from when you sign up or apply to get benefits from Social Security (or the Railroad Retirement Board).

If you’re not sure if you qualify, you can:
⦁    Log into (or create) your secure my Social Security account to find out if you paid Medicare taxes long enough.
⦁     Ask your employer.

If you or your spouse worked for a railroad, you can call the Railroad Retirement Board at 1-877-772-5772.

If you don’t qualify for premium-free Part A: You might be able to buy it. You’ll pay either $278 or $505 each month for Part A, depending on how long you or your spouse worked and paid Medicare taxes.

Remember:

Deductible $1,632 for each inpatient hospital benefit period, before Original Medicare starts to pay.

There’s no limit to the number of benefit periods you can have in a year. This means you may pay the deductible more than once in a year.

How do benefit periods work?

In a hospital:

Start: The day you’re admitted as an inpatient
End: When you haven’t gotten any inpatient hospital care for 60 days in a row

In a Skilled Nursing Facility (SNF):

Start: The day you’re admitted as an inpatient
End: When you haven’t gotten any skilled care in a SNF for 60 days in a row

If you go into a hospital or a SNF after one benefit period has ended, a new benefit period begins. There’s no limit to the number of benefit periods you can have in a year.

Inpatient stay
  • Days 1-60: $0 after you pay your Part A deductible.
  • Days 61-90: $408 copayment each day.
  • Days 91-150: $816 copayment each day while using your 60 lifetime reserve days (In Original Medicare, these are additional days that Medicare will pay for when you’re in a hospital for more than 90 days. You have a total of 60 reserve days that can be used during your lifetime. For each lifetime reserve day, Medicare pays all covered costs except for a daily coinsurance.)
  • After day 150: You pay all costs.
What’s not covered?

Medicare doesn’t pay for:

  • Private-duty nursing
  • ​​​​​​Television in your room
  • Phone in your room

You’ll also pay for a private room, unless it’s medically necessary.

What will I pay if I get mental health services as an inpatient?

If you’re an inpatient at a general or psychiatric hospital, you also pay 20% of the Medicare approved amount for mental health services you get from providers during your stay.

If you’re getting services at a psychiatric hospital, remember that Part A only pays for up to 190 days of inpatient psychiatric care during your lifetime.

Skilled nursing facility stay 
  • Days 1-20: $0 copayment.
  • Days 21-100: $204 copayment each day.
  • Days 101 and beyond: You pay all costs.
Home health care  $0 for covered home health care services.

20% of the Medicare-approved amount (The payment amount that Original Medicare sets for a covered service or item. When your provider accepts assignment, Medicare pays its share and you pay your share of that amount) for durable medical equipment (like wheelchairs, walkers, hospital beds, and other equipment).

Hospice care  $0 for covered hospice care services.

You may also 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.
    What if hospice doesn’t pay for my drug?

    Ask your provider to contact your Medicare drug plan (if you have one) to find out if they’ll cover it.

    What’s not covered (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)