A Simple Guide for Anyone Turning 65
Understanding the Basics of Medicare
Let’s face it—Medicare can be confusing. Between all the parts, plans, and deadlines, it’s easy to feel overwhelmed. But don’t worry. We’re here to break it all down in plain English so you can feel confident about your healthcare decisions.
What Is Medicare Part A?
Most people don’t pay a monthly premium for Medicare Part A in 2025 because they, or their spouse, worked long enough to qualify—typically 40 quarters of Medicare-covered employment—this is called “premium‑free Part A”. When you’re admitted to the hospital, you’ll pay a $1,676 deductible per benefit period before coverage begins. After that, stays up to 60 days are fully covered, but if you’re hospitalized for days 61–90, you’ll owe $419 per day, and if you need more time, you can use one of your 60 lifetime reserve days at $838 per day.
For a Skilled Nursing Facility (SNF) stay after a hospital admission, you pay $0 for the first 20 days, then $209.50 per day for days 21–100, and beyond that you’re responsible for all costs. If you haven’t paid enough Medicare taxes, you can buy Part A with a monthly premium—$285 (for 30–39 quarters) or $518 (for less than 30 quarters). In short, Part A delivers essential coverage for inpatient care and rehab—but it comes with a significant deductible and daily coinsurance for extended stays.
What is Medicare Part B?
Medicare Part B helps cover your everyday healthcare needs—like doctor visits, outpatient services (think lab tests, X-rays, physical therapy), durable medical equipment (canes, walkers, oxygen), and certain home health services. In 2025, most people pay a $185 monthly premium, typically deducted from Social Security, along with an annual deductible of $257. Once you've met that deductible, Medicare usually pays 80% of approved costs, leaving you with the remaining 20%. For example, if your doctor charges $100, Medicare pays $80, and you pay $20.
If your income is higher—based on your 2023 tax return—you may pay more, ranging from $259 up to $628.90 per month, due to the Income-Related Monthly Adjustment Amount (IRMAA). There’s also a 10% permanent late-enrollment penalty for each full year you delay signing up without other coverage. Notably, there’s no annual out-of-pocket cap under Part B, so if you have frequent services, a supplemental plan (like Medigap or a Medicare Advantage plan) might help keep costs down.
What is Medicare Part D?
Medicare Part D is your safety net for prescription drug expenses. In 2025, you’ll likely pay a monthly premium averaging around $46.50, though it varies by plan, plus any income-related surcharge (IRMAA) if your earnings are higher.
You might also face a deductible, up to $590, before your coverage kicks in—some plans offer lower or no deductible but come with higher monthly premiums. After meeting your deductible, you're in the initial coverage phase, where you typically pay 25% of drug costs until your total out-of-pocket spending (deductible, copays, coinsurance) hits $2,000. Once you reach that limit, you enter the catastrophic coverage phase, where Medicare, your plan, and drug manufacturers cover almost all costs, and you pay nothing out-of-pocket for covered drugs for the rest of the year.
Thanks to the Inflation Reduction Act, the old “donut hole” coverage gap is gone, simplified into these stages with the $2,000 out-of-pocket cap—which is a big win if you take multiple or costly medications
Why Work With a Licensed Agent?
✅ Unbiased Guidance
Our agents are licensed to work with many top insurance companies, so they can compare all of your options—not just one. That means you get honest advice that puts your needs first.
✅ Avoid Costly Mistakes
Choosing the wrong plan could mean higher out-of-pocket costs, limited doctors, or missing key benefits. A licensed agent knows how to avoid these common (and costly) errors.
✅ Save Time & Stress
Medicare is complicated—we make it simple. An agent will walk you through your options in plain language, help you enroll on time, and answer your questions every step of the way.
✅ Free to You
There’s no cost to use a licensed agent. No hidden fees. No pressure. Just clear, professional help from someone who cares about getting it right.
👇 Request Your Free Medicare Review Today
Fill out the short form below and get connected with a licensed Medicare agent who will help you review your options and find the plan that’s right for you.
It’s fast, free, and could save you thousands.
Need Medicare Help?
Confused about your options? Don’t go it alone.
📞 Call now for FREE, no-obligation Medicare help!
Our friendly experts are ready to answer your questions and find the right plan for you.
Toll-Free: (800) 579-9492
Medicare has neither reviewed nor endorsed this information. Not connected with or endorsed by the United States government or the federal Medicare program.