Medicare Costs After 65: Premiums, Deductibles, and Help Programs

Medicare helps cover health care costs after 65, but it does not pay for everything. You may still pay a monthly premium, a deductible before coverage starts, and a share of some costs. This article explains those costs in plain language, and the help programs that may lower them. No specific dollar amount is stated here, because amounts can change and can differ by plan and by state — check current figures at medicare.gov before you decide.

Key takeaway: Learn what each part of Medicare covers, what a premium, deductible, and coinsurance mean, and whether a Medicare Savings Program, Extra Help, or free SHIP counseling could help with your costs. Check current figures at medicare.gov — this article does not promise eligibility or savings.

In this article:

• Parts of Medicare in plain language
• What premiums, deductibles, and coinsurance mean
• How costs are usually paid
• Help programs at a glance
• Extra Help for prescription drug costs
• Free help from SHIP
• Checklist for reviewing Medicare costs
• Frequently asked questions
• Official sources

Parts of Medicare in plain language

• Part A — hospital insurance. Helps cover inpatient hospital stays, skilled nursing facility care, hospice care, and home health care.
• Part B — medical insurance. Helps cover doctors' services, outpatient care, home health care, durable medical equipment, and many preventive services.
• Part C — Medicare Advantage. A Medicare-approved plan from a private company that covers most Part A and Part B benefits instead of Original Medicare, and usually also includes drug coverage.
• Part D — prescription drug coverage. Helps cover prescription drug costs. You can join it as a separate drug plan in addition to Original Medicare, or through a Medicare Advantage Plan with drug coverage.
• Medigap. Extra insurance from a private company that helps pay the share of costs in Original Medicare. It is not the same as a Medicare Advantage plan.

Original Medicare means Part A and Part B together. A Medicare Advantage plan replaces Original Medicare for most benefits, so read the plan's own rules about what it covers and what you pay.

What premiums, deductibles, and coinsurance mean

• Premium. A regular amount you pay to keep coverage, often monthly. Different parts and plans can have different premiums.
• Deductible. An amount you pay for covered services before Medicare or your plan starts paying its share. Check your plan notice for the current deductible that applies to you.
• Coinsurance. Your share of the cost of a covered service, usually a percentage. For example, in Original Medicare, coinsurance is usually a percentage — for example, 20% in the description on medicare.gov. That example is not a rule for every plan; your plan may use a different share or a fixed copayment instead.
• Copayment. A fixed amount you may pay for a covered service, such as a doctor visit or a prescription, if your plan uses copayments.

How costs are usually paid

How you pay can depend on the part, the plan, and how you receive benefits. Keep a note of how each premium is paid, and check the plan notice or statement if you are unsure. Do not assume one payment method applies to every premium or every plan. Review your costs once a year and when a plan notice arrives, and keep the notice with your other Medicare paperwork.

Review each premium, deductible, and share of costs, and keep your plan notices together. When you review your coverage, see Medicare Open Enrollment 2026: Your Checklist Before 7 December for a checklist before you decide whether to change plans.

Help programs at a glance

Medicare Savings Programs help from the state paying some Medicare costs. You apply through your state, and the state determines eligibility. In most cases, income and resources must be below a certain limit, and some states do not count certain types or amounts of income and resources. Check current limits at medicare.gov and with your state — this article does not state a dollar limit, because limits can differ by state and can change.

Program	What it can help pay, in general	Notes
Qualified Medicare Beneficiary (QMB)	Part A premiums (if not premium-free), Part B premiums, deductibles, coinsurance, and copayments	Also get Extra Help for prescription drugs
Specified Low-Income Medicare Beneficiary (SLMB)	Part B premiums only	Must have both Part A and Part B; also get Extra Help
Qualifying Individual (QI)	Part B premiums	Must have both Part A and Part B; must apply every year; first-come, first-served; only for people who do not qualify for other Medicaid coverage or benefits; also get Extra Help

Tip: Contact your state to find Medicare Savings Programs, get Medicaid information, and check eligibility for other state programs. Your state, not this article, decides whether you qualify.

Extra Help for prescription drug costs

Extra Help is a Medicare program for people with limited income and resources that helps lower Medicare drug plan costs, such as premiums, deductibles, and coinsurance. People who qualify for a Medicare Savings Program (QMB, SLMB, or QI) also get Extra Help. You can contact the Social Security Administration to apply for Extra Help, and check current figures and rules at medicare.gov. Do not promise yourself a saving amount — check what applies to your own drug plan.

Ask about drug costs and Extra Help, and check your plan notice for current figures.

Free help from SHIP

State Health Insurance Assistance Programs (SHIPs) offer free health insurance counseling for people with Medicare and their families. They can help you choose a plan, review coverage, understand costs, apply for Extra Help, file a complaint or an appeal, and make informed Medicare decisions. Find SHIP help through the Medicare contact page at medicare.gov. This help is free, and it is not the same as buying a plan from a sales agent.

Checklist for reviewing Medicare costs

This checklist collects no information — it is only a list to work through once a year and when a plan notice arrives.

• ☐ I have listed my Part A, Part B, Part C or Part D, and any Medigap coverage.
• ☐ I have noted each premium, deductible, coinsurance, and copayment that applies to me, from my own plan notice.
• ☐ I have noted how each premium is paid, and checked the plan notice or statement if I am unsure.
• ☐ I have checked whether a Medicare Savings Program (QMB, SLMB, or QI) might apply, through my state.
• ☐ I have checked whether Extra Help might lower my Part D drug costs.
• ☐ I have considered free SHIP counseling before choosing or changing a plan.
• ☐ I have not relied on a dollar amount from this article — I checked current figures at medicare.gov.

Frequently asked questions

Does Medicare pay for everything after 65?

No. You may still pay premiums, deductibles, coinsurance, or copayments, depending on your parts and plan. Read your own plan notice for what applies to you.

Where do I apply for a Medicare Savings Program?

Through your state. Your state determines eligibility, and in most cases income and resources must be below a certain limit. Check current limits at medicare.gov and with your state.

Where can I get free, personal help with Medicare choices?

From your State Health Insurance Assistance Program (SHIP), which offers free counseling on choosing a plan, reviewing coverage, understanding costs, applying for Extra Help, and filing a complaint or appeal. Find it through medicare.gov.

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Next steps

• Budget on a Fixed Income After 65 — fit Medicare costs into a monthly plan.

Official sources

• Medicare.gov: Parts of Medicare — Part A, Part B, Part C, Part D, and Medigap
• Medicare.gov: Medicare Savings Programs — QMB, SLMB, QI, and Extra Help
• Medicare.gov: Talk to Someone — SHIP free counseling and state contacts
• Medicare.gov — check current figures

This article is general education only and is not individualized financial, tax, legal, or medical advice. For current figures and your own situation, check medicare.gov and your state. See the Financial Disclaimer.