What do deductible, copayment, and coinsurance mean?
A deductible is what you pay before Medicare starts to pay. A copayment is a set dollar amount, like a flat fee. Coinsurance is a percentage of the cost, like 20%.
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Costs & help paying
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Can my state help pay my Medicare premiums?
Yes. Medicare Savings Programs are state programs that help pay your Medicare premiums, and sometimes your deductibles, coinsurance, and copayments, if your income and resources are limited. You apply through your state.
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Is there a limit on what I pay each year?
Original Medicare (Part A and Part B) on its own has no yearly limit on what you pay out of pocket. Medicare Advantage plans have a yearly limit; once you reach it, you pay nothing for covered services for the rest of the year. And in 2027, your out-of-pocket spending on covered Part D drugs is capped at $2,400.
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What does Part A cost?
Most people pay $0 a month for Part A (hospital insurance) because they or a spouse paid Medicare taxes long enough while working. If you're admitted to the hospital in 2026, you pay a $1,736 deductible.
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What does Part B cost?
In 2026, most people pay $202.90 a month for Part B (medical insurance: doctor visits and outpatient care). You also pay a $283 yearly deductible, then usually 20% of the cost for each covered service.
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What is Extra Help, and could I qualify?
Extra Help is a Medicare program that helps people with limited income and resources pay for Part D (prescription drug) coverage. If you have full Medicaid, get SSI, or a Medicare Savings Program pays your Part B premium, you get Extra Help automatically.
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General education, not individualized advice. For your own situation, you can call 1-800-MEDICARE or your State Health Insurance Assistance Program (SHIP).
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