On September 27, 2024, the Centers for Medicare & Medicaid Services (CMS) released the 2025 premiums, deductibles, and coinsurance amounts for the Medicare Part A and Part B programs, and the 2025 Medicare Part D income-related monthly adjustment amounts.
Medicare Part B Premium and Deductible
Medicare Part B covers physician services, outpatient hospital services, certain home health services, durable medical equipment, and certain other medical and health services not covered by Medicare Part A.
Each year the Medicare Part B premium, deductible, and coinsurance rates are determined according to the Social Security Act. The standard monthly premium for Medicare Part B enrollees is $185 for 2025, of $5.20 from $174.70 in 2024. The annual deductible for all Medicare Part B beneficiaries is $240 in 2025.
Out-of-pocket drug expenses for 2025 are now capped at $2,000, eliminating the infamous “donut hole” gap in drug coverage. The average price of Part D plan deductibles will increase in 2025. Look for your 2025 mid-year notice to inform you of unused supplemental benefits.
Beginning in 2023, certain Medicare enrollees who are 36 months post kidney transplant, and therefore are no longer eligible for full Medicare coverage, can elect to continue Part B coverage of immunosuppressive drugs by paying a premium. For 2023, the immunosuppressive drug premium is $97.10.
Medicare Plan Quotes
Medicare Open Enrollment and Medicare Savings Programs
Medicare Open Enrollment for 2023 will begin on October 15, 2022 and ends on December 7, 2022. During this time, people eligible for Medicare can compare 2023 coverage options between Original Medicare, and Medicare Advantage, and Part D prescription drug plans. In addition to the soon-to-be released premiums and cost sharing information for 2023 Medicare Advantage and Part D plans, the Fee-for-Service Medicare premiums and cost sharing information released today will enable people with Medicare to understand their Medicare coverage options for the year ahead. Medicare health and drug plan costs and covered benefits can change from year to year, so people with Medicare should look at their coverage choices annually and decide on the options that best meet their health needs.
To help with their Medicare costs, low-income seniors and adults with disabilities may qualify to receive financial assistance from the Medicare Savings Programs (MSPs). The MSPs help millions of Americans access high-quality health care at a reduced cost, yet only about half of eligible people are enrolled. The MSPs help pay Medicare premiums and may also pay Medicare deductibles, coinsurance, and copayments for those who meet the conditions of eligibility. Enrolling in an MSP offers relief from these Medicare costs, allowing people to spend that money on other vital needs, including food, housing, or transportation. People with Medicare interested in learning more can visit: https://www.medicare.gov/your-medicare-costs/get-help-paying-costs/medicare-savings-programs.
Medicare Part B Income-Related Monthly Adjustment Amounts
Since 2007, a beneficiary’s Part B monthly premium is based on his or her income. These income-related monthly adjustment amounts affect roughly 7 percent of people with Medicare Part B. The 2023 Part B total premiums for high-income beneficiaries with full Part B coverage are shown in the following table:
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Full Part B Coverage
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Beneficiaries who file individual tax returns with modified adjusted gross income:
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Beneficiaries who file joint tax returns with modified adjusted gross income:
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Income-Related Monthly Adjustment Amount
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Total Monthly
Premium Amount
|
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Less than or equal to $97,000
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Less than or equal to $194,000
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$0.00
|
$164.90
|
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Greater than $97,000 and less than or equal to $123,000
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Greater than $194,000 and less than or equal to $246,000
|
$65.90
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$230.80
|
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Greater than $123,000 and less than or equal to $153,000
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Greater than $246,000 and less than or equal to $306,000
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$164.80
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$329.70
|
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Greater than $153,000 and less than or equal to $183,000
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Greater than $306,000 and less than or equal to $366,000
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$263.70
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$428.60
|
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Greater than $183,000 and less than $500,000
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Greater than $366,000 and less than $750,000
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$362.60
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$527.50
|
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Greater than or equal to $500,000
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Greater than or equal to $750,000
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$395.60
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$560.50
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The 2023 Part B total premiums for high-income beneficiaries with immunosuppressive drug only Part B coverage are shown in the following table:
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Part B Immunosuppressive Drug Coverage Only
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Beneficiaries who file individual tax returns with modified adjusted gross income:
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Beneficiaries who file joint tax returns with modified adjusted gross income:
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Income-Related Monthly Adjustment Amount
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Total Monthly
Premium Amount
|
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Less than or equal to $97,000
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Less than or equal to $194,000
|
$0.00
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$97.10
|
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Greater than $97,000 and less than or equal to $123,000
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Greater than $194,000 and less than or equal to $246,000
|
$64.70
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$161.80
|
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Greater than $123,000 and less than or equal to $153,000
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Greater than $246,000 and less than or equal to $306,000
|
$161.80
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$258.90
|
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Greater than $153,000 and less than or equal to $183,000
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Greater than $306,000 and less than or equal to $366,000
|
$258.90
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$356.00
|
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Greater than $183,000 and less than $500,000
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Greater than $366,000 and less than $750,000
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$356.00
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$453.10
|
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Greater than or equal to $500,000
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Greater than or equal to $750,000
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$388.40
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$485.50
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Premiums for high-income beneficiaries with full Part B coverage who are married and lived with their spouse at any time during the taxable year, but file a separate return, are as follows:
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Full Part B Coverage
|
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Beneficiaries who are married and lived with their spouses at any time during the year, but who file separate tax returns from their spouses, with modified adjusted gross income:
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Income-Related Monthly Adjustment Amount
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Total Monthly Premium Amount
|
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Less than or equal to $97,000
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$0.00
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$164.90
|
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Greater than $97,000 and less than $403,000
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$362.60
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$527.50
|
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Greater than or equal to $403,000
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$395.60
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$560.50
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Medicare Part A covers inpatient hospital, skilled nursing facility, hospice, inpatient rehabilitation, and some home health care services. About 99 percent of Medicare beneficiaries do not have a Part A premium since they have at least 40 quarters of Medicare-covered employment.
The Medicare Part A inpatient hospital deductible that beneficiaries pay if admitted to the hospital will be $1,600 in 2023, an increase of $44 from $1,556 in 2022. The Part A inpatient hospital deductible covers beneficiaries’ share of costs for the first 60 days of Medicare-covered inpatient hospital care in a benefit period. In 2023, beneficiaries must pay a coinsurance amount of $400 per day for the 61st through 90th day of a hospitalization ($389 in 2022) in a benefit period and $800 per day for lifetime reserve days ($778 in 2022). For beneficiaries in skilled nursing facilities, the daily coinsurance for days 21 through 100 of extended care services in a benefit period will be $200.00 in 2023 ($194.50 in 2022).
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Part A Deductible and Coinsurance Amounts for Calendar Years 2022 and 2023 by Type of Cost Sharing
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|
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2022
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2023
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Inpatient hospital deductible
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$1,556
|
$1,600
|
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Daily coinsurance for 61st-90th Day
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$389
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$400
|
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Daily coinsurance for lifetime reserve days
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$778
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$800
|
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Skilled Nursing Facility coinsurance
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$194.50
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$200.00
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Enrollees age 65 and over who have fewer than 40 quarters of coverage and certain persons with disabilities pay a monthly premium in order to voluntarily enroll in Medicare Part A. Individuals who had at least 30 quarters of coverage or were married to someone with at least 30 quarters of coverage may buy into Part A at a reduced monthly premium rate, which will be $278 in 2023, a $4 increase from 2022. Certain uninsured aged individuals who have less than 30 quarters of coverage and certain individuals with disabilities who have exhausted other entitlement will pay the full premium, which will be $506 a month in 2023, a $7 increase from 2022.
For more information on the 2023 Medicare Parts A and B premiums and deductibles Notices (CMS-8080-N, CMS-8081-N, CMS-8082-N), please visit:
CMS-8080-N: https://www.federalregister.gov/public-inspection/2022-21180/medicare-program-calendar-year-2023-inpatient-hospital-deductible-and-hospital-and-extended-care
CMS-8081-N:https://www.federalregister.gov/public-inspection/2022-21176/medicare-program-cy-2023-part-a-premiums-for-the-uninsured-aged-and-for-certain-disabled-individuals
CMS-8082-N:https://www.federalregister.gov/public-inspection/2022-21090/medicare-program-medicare-part-b-monthly-actuarial-rates-premium-rates-and-annual-deductible
Medicare Part D Income-Related Monthly Adjustment Amounts
Since 2011, higher income beneficiaries’ Part D monthly premiums are based on income. These income-related monthly adjustment amounts affect roughly 8 percent of people with Medicare Part D. These individuals will pay the income-related monthly adjustment amount in addition to their Part D premium. Part D premiums vary from plan to plan and roughly two-thirds of beneficiaries pay premiums directly to the plan, while the remaining beneficiaries have their premiums deducted from their Social Security benefit checks.
Regardless of how a beneficiary pays their Part D premium, the Part D income-related monthly adjustment amounts are deducted from Social Security benefit checks or paid directly to Medicare. The 2023 Part D income-related monthly adjustment amounts for high-income beneficiaries are shown in the following table:
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Beneficiaries who file individual tax returns with modified adjusted gross income:
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Beneficiaries who file joint tax returns with modified adjusted gross income:
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Income-related monthly adjustment amount
|
|
Less than or equal to $97,000
|
Less than or equal to $194,000
|
$0.00
|
|
Greater than $97,000 and less than or equal to $123,000
|
Greater than $194,000 and less than or equal to $246,000
|
12.20
|
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Greater than $123,000 and less than or equal to $153,000
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Greater than $246,000 and less than or equal to $306,000
|
31.50
|
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Greater than $153,000 and less than or equal to $183,000
|
Greater than $306,000 and less than or equal to $366,000
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50.70
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Greater than $183,000 and less than $500,000
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Greater than $366,000 and less than $750,000
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70.00
|
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Greater than or equal to $500,000
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Greater than or equal to $750,000
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76.40
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Premiums for high-income beneficiaries who are married and lived with their spouse at any time during the taxable year, but file a separate return, are as follows:
|
Beneficiaries who are married and lived with their spouses at any time during the year, but file separate tax returns from their spouses, with modified adjusted gross income:
|
Income-related monthly adjustment amount
|
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Less than or equal to $97,000
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$0.00
|
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Greater than $97,000 and less than $403,000
|
70.00
|
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Greater than or equal to $403,000
|
76.40
|
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