Premium
The amount paid regularly for coverage. You generally continue paying the Part B premium even when enrolled in Medicare Advantage.
Medicare Costs
Medicare costs explained
Understanding premiums, deductibles, copays, coinsurance, and out-of-pocket limits makes plan comparisons more meaningful.
Five cost terms to understand
Deductible
The amount you may need to pay for covered services or drugs before the coverage begins paying its share.
Copayment
A fixed amount charged for a covered service or prescription, such as a doctor visit or medication.
Coinsurance
A percentage of the covered cost that you pay after applicable deductible requirements are met.
Out-of-pocket limit
Medicare Advantage plans set an annual limit for covered medical services. Original Medicare does not have the same yearly medical limit unless other coverage helps.
IRMAA
Some beneficiaries pay income-related adjustments in addition to standard Part B or Part D premiums.
Look beyond the monthly premium
A lower premium does not automatically mean lower total spending. Consider how often you use medical services, your prescription costs, provider network rules, expected copays, deductibles, and the plan’s annual medical out-of-pocket limit.
Compare inpatient hospital and outpatient service costs.
Check specialist, diagnostic imaging, therapy, and durable equipment costs.
Review every prescription by tier and pharmacy.
Confirm whether out-of-network services are covered.
Keep paying required Medicare premiums.
Review financial assistance programs if income and resources are limited.
Medicare amounts and private-plan costs can change each year. This page explains cost structure rather than quoting figures that may become outdated.
See current costs at Medicare.govReview your situation with Gala Health
Bring your coverage information, doctors, prescriptions, preferred pharmacies, and questions for a personalized plan review.
Request a plan review