Most people don’t pay a premium for Part A because they or a spouse, typically, already qualified for premium-free coverage through their payroll tax contribution over at least 40 quarters of coverage, while working.
Typically, you have free Part A if you are age 65 or more, and eligible for monthly Social Security or Railroad Retirement Board (RRB) retirement benefits.
If you don’t qualify for premium free Part A coverage, you can get Part A coverage by paying a monthly premium, provided you are a U.S. citizen or lawful permanent resident with 5 years of continuous residency in the U.S. prior to the month of filing an application for Medicare.
For 2025:
In addition to paying the Part A premium, in most cases you must also enroll in Part B and pay the Part B premium. You can buy Part B only, without Part A.
For the calendar year 2025, for each benefit period, the deductible is $1,676 ($1,632 in 2024)and coinsurance as follows:
For Skill Nursing Facility (SNF) stay you pay for each benefit period:
A benefit period begins the first day an enrollee is admitted to a hospital or received extended care services, and it ends when the enrollee has not been an inpatient of a hospital or other facilities for 60 consecutive days
For CY 2025, the projected standard Part B monthly premium amount is $185 ($174.70 in 2024) or higher, depending on your Modified Adjusted Gross Income (MAGI) filed with IRS in 2023. This corresponds to about 25% of the full premium, and the remaining is paid by the federal government.
The premium then increases by income bracket to 35%, 50%, 65%, 80%, and 85% of the full premium. According to CMS, for 2024 about 8% of the beneficiaries with Part B are affected by the premium adjustment known as Income Related Monthly Adjustment Amount (IRMAA).
The calendar year 2025 Part B deductible is $257 ($240 in 2024). After your deductible is met, you typically 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 (DME)
You have the option to enroll in the Original Medicare or in a Medicare Advantage Plan. If you decide to enroll in the Original Medicare, you need to know:
The OEP is sometimes referred to by CMS as General Enrollment Period (GEP).