1. Original Medicare (Parts A & B)

Original Medicare is a federal health insurance program that includes Part A (hospital insurance) and Part B (medical insurance).

• Part A Deductible (2025): $1,632 per benefit period
• Hospital Stay Costs:
  • Days 1-60: $0 coinsurance
  • Days 61-90: $408 per day
  • Days 91+: $816 per “lifetime reserve” day (up to 60 days)
• Part B Premium: $174.70 per month
• Part B Deductible: $240 per year
• Part B Coinsurance: 20% of Medicare-approved costs after deductible
• No out-of-pocket maximum (consider Medigap for extra coverage)

2. Medicare Advantage (Part C)

Medicare Advantage is an alternative to Original Medicare, offered by private insurers, often including extra benefits.

• Includes Parts A & B (may include Part D for drug coverage)
• Additional Benefits: Dental, vision, hearing, wellness programs
• Annual Out-of-Pocket Maximum: $8,850 (2025)
• Copays & Coinsurance: Vary by plan
• Provider Network: Limited to HMO/PPO networks

3. Medicare Supplement Plans (Medigap)

Medigap policies help cover out-of-pocket costs from Original Medicare, such as deductibles and copayments.

• Available to those with Original Medicare (not Medicare Advantage)
• Variety of Plans (A-N): Each offering different levels of coverage
• Helps Cover: Part A & B coinsurance, deductibles, and excess charges
• Does Not Include: Prescription drug coverage (must enroll in Part D separately)

4. Stand-Alone Prescription Drug Plans (Part D)

Part D plans provide prescription drug coverage for those with Original Medicare.

• Monthly Premium: Varies by plan
• Annual Deductible: Up to $545 (2025)
• Coverage Phases:
  • Initial Coverage: After deductible, co-pays apply
  • Donut Hole: After spending $5,030, costs increase temporarily
  • Catastrophic Coverage: After $8,000 in out-of-pocket costs, reduced costs apply