Medicare Deductibles in 2025: Every Dollar You Need to Know

If you're on Original Medicare in 2025, two deductibles shape nearly every healthcare cost you'll face: the Part A deductible for hospital stays and the Part B deductible for outpatient services. These aren't small numbers, and understanding exactly how they work — including the tricky way Part A resets — can save you from a genuinely shocking bill. Let's walk through each one carefully, because the details matter more than most people realize.

The Medicare Part A deductible in 2025 is $1,676. This applies each time you begin a new "benefit period," which starts the day you're admitted to a hospital or skilled nursing facility and ends after you've been out of that facility for 60 consecutive days. Here's where people get caught off guard: this is not an annual deductible. If you're hospitalized in January, recover, go home, and then are readmitted in April — more than 60 days later — you owe the full $1,676 again. A beneficiary with two separate hospital stays in a single calendar year could owe $3,352 in Part A deductibles alone. After you've paid that per-period deductible, Medicare Part A covers your full hospital costs for days 1 through 60. From days 61 to 90, you pay a daily coinsurance of $419 in 2025. Beyond day 90, you're drawing on your 60 lifetime reserve days, which carry a $838 daily coinsurance in 2025.

The Medicare Part B deductible in 2025 is $257 per year. Unlike Part A, this one resets every January 1 and you only pay it once per calendar year. Once you've met that $257 threshold, Medicare Part B generally pays 80% of the Medicare-approved amount for covered outpatient services — doctor visits, lab work, durable medical equipment, outpatient surgery, and more. You remain responsible for the remaining 20%, with no cap on that out-of-pocket exposure under Original Medicare alone. That 20% coinsurance with no ceiling is one of the most significant financial risks in Original Medicare, and it's the primary reason many beneficiaries purchase a Medigap policy or enroll in Medicare Advantage instead.

The standard Part B premium in 2025 is $185 per month, though higher-income beneficiaries pay more through what's called IRMAA — the Income-Related Monthly Adjustment Amount. If your modified adjusted gross income from two years prior (meaning your 2023 tax return) exceeded $106,000 as an individual or $212,000 as a married couple filing jointly, you'll pay a surcharge on top of that $185 base premium. The IRMAA tiers in 2025 push the monthly Part B premium as high as $628.90 for the highest earners. If your income has dropped significantly since that 2023 return — due to retirement, the death of a spouse, or another life-changing event — you can appeal your IRMAA using IRS Form SSA-44 to request a reassessment based on more recent income.

For skilled nursing facility care, Part A covers the full cost for days 1 through 20 of each benefit period, but only after a qualifying hospital stay of at least three days. From days 21 through 100, you pay $209.50 per day in coinsurance in 2025. After day 100, Medicare pays nothing — all costs fall to you. This is a critical gap that surprises many beneficiaries who assume Medicare covers long-term nursing care. It does not. Long-term care insurance or Medicaid (for those who qualify financially) are the primary tools for covering extended nursing home stays.

Medigap plans, sold by private insurers, are specifically designed to fill these gaps. As of 2025, the most popular options include Plan G, which covers the Part A deductible, Part A coinsurance, Part B coinsurance (that 20%), and foreign travel emergency care — but does not cover the Part B deductible. Plan N covers most of the same costs as Plan G but requires copays of up to $20 for some office visits and up to $50 for emergency room visits that don't result in inpatient admission. Plan G High-Deductible is a lower-premium option where you pay a $2,870 deductible in 2025 before the plan kicks in, which can work well for beneficiaries who are generally healthy and want catastrophic protection at a lower monthly cost. Note that Plan F — which covered everything including the Part B deductible — is no longer available to anyone who became eligible for Medicare on or after January 1, 2020. If you were eligible before that date, you may still be able to purchase Plan F, but it's worth comparing premiums carefully since the pool of Plan F enrollees is aging and premiums have been rising faster than other plans.

Medicare Advantage plans (Part C) handle deductibles very differently. Instead of the Part A and Part B deductible structure, Medicare Advantage plans set their own cost-sharing rules, which vary widely by plan and by county. Some Medicare Advantage plans in 2025 carry a $0 medical deductible, while others may have a deductible of several hundred dollars before covering certain services. Critically, all Medicare Advantage plans are required by law to cap your annual out-of-pocket costs — in 2025, that cap can be no higher than $9,350 for in-network services and $14,000 for combined in- and out-of-network costs. Original Medicare has no such cap, which is why comparing total potential exposure — not just premiums — is essential when choosing between Original Medicare with a Medigap plan versus Medicare Advantage.

If you're enrolled in both Medicare and Medicaid (a "dual eligible" beneficiary), your cost-sharing obligations may be significantly reduced or eliminated entirely. Medicaid can act as a secondary payer, covering deductibles and coinsurance that Medicare doesn't pay. Additionally, Medicare Savings Programs — including the Qualified Medicare Beneficiary (QMB) program — can help lower-income beneficiaries have their Part A and Part B premiums, deductibles, and coinsurance paid by their state Medicaid program. Income and asset limits vary by state, so checking with your State Health Insurance Assistance Program (SHIP) counselor is the most direct way to find out if you qualify. SHIP counseling is free, unbiased, and available in every state through the Eldercare Locator at eldercare.acl.gov.

The Annual Enrollment Period — October 15 through December 7 each year — is your primary window to switch between Original Medicare and Medicare Advantage, or to change Medicare Advantage plans. Changes take effect January 1. If you miss AEP, the Open Enrollment Period from January 1 through March 31 lets Medicare Advantage enrollees switch to a different Advantage plan or return to Original Medicare, with coverage starting the first day of the following month. Medigap enrollment is most straightforward during your six-month Medigap Open Enrollment Period, which begins the month you turn 65 and are enrolled in Part B — during this window, insurers cannot deny you coverage or charge higher premiums based on health conditions. Outside that window, medical underwriting typically applies, with the exception of beneficiaries in states that offer a birthday rule, including California, Oregon, Nevada, Illinois, and several others, which allow a 30-day window each year around your birthday to switch Medigap plans without underwriting.