Understanding Medicare's out-of-pocket costs

3-minute readPublished 03/28/2024Updated 05:07 AM EST, 09/12/2025

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When you first sign up for Medicare, the costs can feel overwhelming. Between premiums, deductibles and copayments, it's easy to get confused about what you'll actually pay for your healthcare. Let's break down Medicare's out-of-pocket costs so you can better plan for your medical expenses and avoid surprise medical bills.

Don’t be frightened by the numbers. You have options.

One of the first things you probably want to know when considering a Medicare plan is what it covers. That makes perfect sense, but it’s important to know what Medicare doesn’t cover, as well. Those numbers can add up.

For example, you might be surprised to learn that Original Medicare offers limited coverage for most dental services,¹ most corrective lenses² or hearing aids.³ So if a dental visit for a toothache turns into a $1,000 bill for a root canal, you’ll pay that out of pocket.

And the next time you really can’t find your glasses? Yep, you’ll be paying out-of-pocket for a new pair.

Add to that out-of-pocket costs for plan copays, deductibles and monthly premiums and you might start feeling the pinch.

An unexpected illness or injury requiring a hospital stay can send those numbers through the roof.

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3-minute readPublished 03/28/2024Updated 05:07 AM EST, 09/12/2025

Here’s a helpful snapshot of your choices

Original Medicare Part A and Part B for 2025


	Costs
Part A premium	People who’ve worked for 10 years or more, and had Social Security taxes withheld, generally don’t have to pay a premium for Part A.
Part A deductible and coinsurance⁴	$1,676 deductible for each benefit period* Days 1–60: $0 coinsurance for each benefit period Days 61–90: $419 coinsurance per day of each benefit period Days 91 and beyond: $838 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
Part B premium⁵	The standard Part B monthly premium amount in 2025 is $185 or higher, depending on your income
Part B deductible and coinsurance⁶	In 2025, the annual deductible for Part B coverage is $257, after which you typically pay 20% of the Medicare-approved amount for most doctor services, outpatient therapy, and durable medical equipment (DME)
Annual maximum out-of-pocket costs	There is no maximum out-of-pocket limit with Original Medicare

Optional Medicare Part D and Medicare Supplement plans


	Costs
Part D premium (prescription drug plan)	Part D premiums, deductibles and copays vary by plan See costs for our Medicare prescription drug plans
Medicare Supplement insurance	There is a monthly premium for these plans. Medicare Supplement plans help pay some of the healthcare costs that Original Medicare doesn't cover, like copayments, coinsurance, and deductibles. They generally don't cover long-term care, vision or dental care, hearing aids, eyeglasses, or private-duty nursing. See costs for our Medicare Supplemental plans
Optional supplemental benefits: vision, dental and fitness	There is a monthly premium for these plans.

Medicare Advantage (offered by private insurers like Humana)


	Costs
Part C premium	Part C premiums, deductibles and copays vary by plan. Compare costs for Humana’s Medicare Advantage (Part C) plans.
Annual maximum out-of-pocket costs	All Medicare Advantage plans offer an annual maximum out-of-pocket limit.

*A benefit period begins the day you're admitted as an inpatient in a hospital or skilled nursing facility (SNF). The benefit period ends when you haven't gotten any inpatient hospital care (or skilled care in a SNF) for 60 days in a row. If you go into a hospital or a SNF after 1 benefit period has ended, a new benefit period begins. You must pay the inpatient hospital deductible for each benefit period. There's no limit to the number of benefit periods. Having to spend time in the hospital several times over the course of a single year can also increase these costs.