I'm confused about all these different Medicare costs - premiums, deductibles, copays. How do they all work together?

Question

Diana Garner · Accepted Answer

All parts of Medicare have some cost associated, whether it be a premium, deductibles, copays for services, or even a max out-of-pocket.

Premiums are the payments you make for the coverage. Deductibles are the amount you must pay out-of-pocket before your coverage will pay anything. Copays are the amount you pay for specific services after meeting your deductible.

Medicare Part A is free once you retire if you or your spouse worked for the last 40 quarters (10 years) before you signed up, because you paid taxes while working. Medicare Part A:
     * Has a deductible for each benefit period (every 60 days) for inpatient hospital stays. 
     * Has copays for hospital stays longer than 60 days. 
     * Has daily coinsurance for days 61-90 and 91-150. 

Medicare Part B has a premium that comes out of your Social Security check before it is dispersed to you. If you are not receiving Social Security, you must pay the premium for Part B out-of-pocket until you start drawing your Social Security. Medicare Part B:
     * Has an annual deductible. 
     * Does not have copays for most services. 
     * Has a 20% coinsurance for most services after the deductible is met. 

Medicare Supplements (Medigap) provide benefits to help cover out-of-pocket costs like deductibles, coinsurance, & copays. Each Med Sup has a premium, & each one has different benefits. Medigaps:
     * Help pay the 20% coinsurance for services covered by Original Medicare Part B (medical insurance). 
     * Many cover the Medicare Part A (hospital insurance) deductible.
     * May cover additional days in the hospital after Medicare benefits are used up. 
     * Some may cover costs for skilled nursing facilities, hospice care, excess charges from non-participating providers, & foreign travel health care emergencies. 

Medicare Advantage usually does not have premiums, but may have a deductible(s), has copays for services, & an annual max out-of-pocket.

Gary Church · Answer

When it comes to Medicare and all the different Medicare plans, the best approach is to understand how you'll use the plans now and in the future. The best way to do this is to meet with a licensed Medicare agent who can help you understand your options.

Answered by Gary Church on September 23, 2025

Broker Licensed in Ca, AZ, NV & TX

Answered by Gary Church Medicare Insurance Agent

Steve and Sue Brauer · Answer

The "premiums" are what people pay each month, no matter if you use the Medicare plan or not. That is the cost of having the plan. Some plans have a "deductible" which means that when you receive covered services, you will pay towards the deductible first, before you realize any "benefit" on the plan. The copays are pre determined costs that you'll pay for certain services, based on your plan.

Answered by Steve and Sue Brauer on April 14, 2025

Broker Licensed in AZ & CA

Answered by Steve and Sue Brauer Medicare Insurance Agent

Norman Smith · Answer

Premiums are like a car payment. It’s what it costs to keep a policy in place.
Deductibles are the amount you need to pay out of pocket BEFORE your benefits take place. And Co-Insurance or Co-Pays are the required payment directly to the functionary that keeps the insurance rates lower for the insured. It seems a little redundant I know, but little things like a Co-pay sometimes stop the abuse of the system once someone has met their deductible.

William Lawler · Answer

Hello, somebody out there confused about all the costs associated with Medicare? Well, let me see if I can explain for you.

Number one is a premium. A premium is what you actually pay for the health care coverage. Next, there are deductibles, be it a medical deductible or a drug deductible. There are two separate things. These are what you're liable for, what you pay before the health insurance itself kicks in.

Next, there are co-pays when you go to a doctor, like a specialist or something like that. You might have to pay $30 or $40 for that visit. That's a co-pay. Co-insurance is like Medicare. Medicare is 80% and 20%. Your 20% is your co-insurance that you're liable for.

Voss Speros · Answer

Voss Speros here, Greek god of Medicare Talk, about Medicare. So the question is, I'm confused about all the different Medicare costs, premiums, copays, deductibles, and how do they all work together? That is a confusing topic, I'm not gonna lie.

So there are the premiums for the plans, the supplemental, and a premium for that advantage. No premium for Part A, and Part B has a premium. There are copayments and the deductibles. The deductibles come out on the Medicare rate. There is a deductible for a hospital of about $1,600 and a Part B deductible of about $100 to $200.

So you gotta pay a deductible first before the plan will kick in and pay anything else. And then this plan says no deductibles, not really. This maximum out-of-pocket, the most you pay in copayments over the course of a year, when you reach that number, the plan pays 100% past that. So deductibles are what you pay upfront, and then the plan kicks in.

Usually, you get a supplemental with a high deductible, or you get a lower premium but you pay the deductible of $2,800. You gotta pay the $2,000 first in copayments, all at the time of service. The insurance company covers so much, and you're responsible for so much. So that's a copayment.

There is a cost of insurance, a cost share on some things where you're gonna pay your share of the total cost, and the insurance will pay to share the total cost. It's like a copayment. A lot of plans offer up to a certain amount, so sometimes the copayments are 20% to 40%, depending on the plan. So keep that in mind.

Premiums are pretty easy. It's just what you pay for the plan. So how does it all work together? Depending on the plan, you get a supplemental plan, you pay a premium for it, and for Part D, you pay a premium for that. The Part D has a deductible of about $600. You pay first for your drugs before the plan steps in, and then you pay your copayment.

The supplemental plan doesn't cover Part B's deductible by $280. So you're gonna come out of pocket for the first two things when you go to a doctor. And then it pays off past that. So that's premiums and deductibles.

And then it is generally no premium, no deductible, and just copayments for service. When you go see the doctor or a specialist, you pay $5 or $20. You're gonna naturally pay $120, whatever it is. So that's how they all work down.

But it's a breakdown of everything. You gotta look at both sides, all the players, and then understand how to break it down. I'm asked, try it out. Have a good day. Hope that helps. Give us a call.

Jonathan Potter · Answer

Premium is the monthly cost of the plan. 
Deductible is the money that YOU pay before the plan pays anything.
Copays are the cost for care that you have to pay.
All the money that you spend out of your pocket for medical (not prescription) costs goes towards your max out of pocket. Once you hit your max then you don't pay any more and the plan pays the rest of your medical costs for the rest of the year before it resets in January.

Ronnie Robinson Jr · Answer

We cover this in a no-obligation Medicare 101, where this is explained in detail. It varies plan to plan, as some do not have deductibles.

Nikki Rowland · Answer

Medicare costs come in a few parts. Premiums are what you pay each month just to have coverage. Deductibles are the amount you pay out of pocket before Medicare starts helping. Then, for most services, you’ll still have copays or coinsurance, which is your share of the cost. A supplement or Medicare Advantage plan can help reduce these out-of-pocket costs.

Answered by Nikki Rowland on May 5, 2025

Broker Licensed in SC & NC

Answered by Nikki Rowland Medicare Insurance Agent

Justin Doherty · Answer

The premium is the amount you pay every month for your insurance. Medicare Part B premiums are withheld from your Social Security benefit. If you have a Medicare Supplement policy or a Medicare Advantage plan, you may have an additional premium. When you need services, you must first pay your deductible amount to the provider(s) (unless your plan has a $0 deductible). Once you have paid that amount, you generally have a copay amount payable for each service. Some services will require a coinsurance percentage instead of a flat copay amount. Generally, the coinsurance is 20% and those are applied to services like Durable Medical Equipment, Medicare Part B covered medications (IV, Infusions, etc.), Diabetic supplies, etc.

Answered by Justin Doherty on July 10, 2025

Broker Licensed in PA, CO, CT & 11 other states

Answered by Justin Doherty Medicare Insurance Agent

Ellen Diehl · Answer

Are you turning 65 soon?  If so I can walk you through all of it.  If you are already on an Advantage plan, you are stuck.

Mitzi Davis · Answer

There are many different ways to explain all of this. My best advice is to contact a local independent broker/agent to sit down with you and explain how they all tie together. It can be very confusing without seeing it in front of you!

Answered by Mitzi Davis on May 20, 2026

Broker Licensed in KS, AR, IA & 6 other states

Answered by Mitzi Davis Medicare Insurance Agent

Ezel McIntee · Answer

Medicare costs work together like this: you pay a monthly premium to keep your coverage, a deductible before Medicare starts paying, and then copays or coinsurance as your share of each service. Think of it like a team effort Medicare covers most costs once you’ve met your share, but the amount depends on the plan you choose. Contact me for a more in-depth explanation and personalized guidance.

Answered by Ezel McIntee on November 11, 2025

Broker Licensed in OK

Answered by Ezel McIntee Medicare Insurance Agent

Ron Kaemmerer · Answer

That’s a hard question to answer without knowing your plan. It would be easier to explain if you want to give me a call

Maureen Gildea · Answer

Each year Medicare sends out a new book.    The details are in the book.   

You can also reach out to a Licensed Professional to assist in explaining your options.

Frank Buonomo · Answer

Everyone's situation is different due to available plans, medical requirements and prescription drugs. To best understand how they work together speak with a licensed insurance agent. Generally, Advantage, medigap supplements and drug plans all work with Medicare coverage.

Answered by Frank Buonomo on February 9, 2026

Agent Licensed in NV, CA, ID & IL, NM, OR & TX

Answered by Frank Buonomo Medicare Insurance Agent

John Henley · Answer

It would probably be easier if we had a live conversation. Feel free to contact 
John

Steven Bleicher · Answer

There are professional Medicare agents who are trained to teach prospects about our quirky healthcare system. I will never understand how folks who are about to become Medicare-eligible seemingly refusing to speak with a minimum of 2-3 experienced agents?!? With that # of interviews, you should receive a well-rounded review! Moreover, you will have established a relationship with an expert with whom you continue to work with as you age. He/she is going to be vital cog for all of your future health needs! Please be sure not to talk to a “captive agent” who is affiliated with only one insurance company as that agent can only offer 1 firm's options! That means that only an independent agent, a.k.a., a broker can write a wide range of Medicare-compliant plans.

Answered by Steven Bleicher on May 24, 2025

Broker Licensed in AZ

Answered by Steven Bleicher Medicare Insurance Agent

DeeDee Whitlock · Answer

My best advice is to meet with a local agent who specializes in ALL Medicare products and is referred to you by your doctors office or a friend who has good knowledge of that agents reputation

Chad Watkins · Answer

What does Medicare cover and not cover? To answer this question, we need to take a look at the two different parts of Medicare. Medicare Part A is your hospital coverage, and Part B is your medical coverage. For Part A, typically people do not pay a premium unless you did not work for at least 40 quarters within your lifetime. But Part A is gonna cover your inpatient hospital care, some skilled nursing care, and hospice care. There is a deductible of $1,676 every time you go in the hospital. If you're there more than 60 days, there's a co-pay of $419 per day. From day 91 to 150, it goes up to $838 per day. After that, you'll be paying for everything as it is not covered. For skilled nursing facility care, Medicare will cover you for the first 20 days, and then after that, it's $209.50 per day up to day 100. After day 100, you're not covered, so everything will be out of pocket. Your Part B covers your doctor services, your outpatient services, including surgery and some other services and supplies that are not covered by Part A. There is a premium for your Part B. Most people will pay $185 per month, but it does go up based on your income. Part B has an annual deductible of $257. After that, 20% is what your co-insurance would be. So there are two different types of plans that you can get: Medicare Supplement and Medicare Advantage to cover the things that Medicare does not cover.

Don Golding · Answer

Premiums are payments for a policy; they do not count towards a deductible or a maximum out-of-pocket expense. Most people will pay the Medicare Part B premium. There may be additional premiums based on the type of additional policies a beneficiary has enrolled in.

Deductibles are the money you pay before a plan pays for services.  Generally, these payments count towards your maximum out-of-pocket.

Copays (and co-insurances) are the costs of your services and count toward your maximum out-of-pocket.

You can find specific amounts in your plan's summary of benefits document.

Victoria R. Trevino · Answer

Educating clients on the 'Medicare Basics' is the best way to explain premiums, deductibles and copays. I work directly with clients to understand out-of-pocket expenses and how to plan for healthcare costs.

Answered by Victoria R. Trevino on April 27, 2026

Broker Licensed in TX & NM

Answered by Victoria R. Trevino Medicare Insurance Agent

Greg Giordano · Answer

Medicare costs involve a combination of premiums, deductibles, and copays/coinsurance. Premiums are monthly payments for your insurance, while deductibles are the amount you pay for healthcare services before your insurance starts covering costs. Copays are fixed amounts you pay for specific services, and coinsurance is a percentage of costs you pay after the deductible

Answered by Greg Giordano on August 1, 2025

Broker Licensed in FL, AZ, CO & 15 other states

Answered by Greg Giordano Medicare Insurance Agent

Allison Chapman · Answer

It can be confusing; there are costs to Medicare, your Part B has a monthly premium, some plans have a monthly premium depending on what you choose, and they have copays also. I would be happy to go over that with you so you can understand. Contact me, my name is Allison, and I am a licensed insurance broker.

Answered by Allison Chapman on November 11, 2025

Agent Licensed in NC, FL, OH, SC & TN

Answered by Allison Chapman Medicare Insurance Agent

Angela Trinidad · Answer

Premiums are what you pay per month for your plan.
Deductibles are what you need to pay before the plan pays. 

Copay are set amounts on what you have to pay for your medical hospital and Rx visits 

Consonance are percentages you may pay instead of copays

Toyin Adeleye · Answer

I'm glad you're taking steps to learn! I'll first explain the terms themselves: A Deductible is the amount you pay for services before the plan starts covering you (if your deductible is $100, the first time you use a covered service you'll pay that $100 towards it). After you meet your deductible, you start paying copays or coinsurance (your portion) for each service you use, when you use it, based on your plan- a copay will be a fixed amount (ie $45 for a doctor's visit), while coinsurance is a percentage of the costs (ie 20% for a doctor's visit). The premium is the fixed amount you pay- typically on a monthly basis- for the plan itself (ie the premium for GOLDPLAN is $30 a month). You're covered by the plan you choose as long as you pay that monthly premium. 


Original Medicare is Part A (Hospital insurance) and Part B (Medical insurance). You pay the part B premium (for 2026 the standard is $202.90/mo). There is no premium that comes with Part A for most people, but there is a deductible for both part A (about $1700) and Part B ($283). Medicare spells out all the copays/ coinsurance that come with different services, and whether they are considered a part A service or Part B service. If you're using a Medicare Supplement or Medicare Advantage plan, your costs will look different based on the way those plans interact with Medicare, but you pay the part B premium on top of whatever premium you pay with these plans.  Part D (prescription drug insurance) often does not come with a premium itself unless you have a penalty, but the carriers will often have their own premiums that come with the Part D plans they offer (usually low or $0 plans) . I hope this helps, but if you get in touch I'm happy to explain these thing to you more in depth.

Fred Manas · Answer

Medicare costs work together in a tiered system. You pay a monthly premium to keep your coverage active, plus you may have to pay a deductible before insurance kicks in. After the deductible, you'll likely pay a copay or coinsurance for each service. 
Elaboration:
Premiums:
These are the monthly fees you pay to maintain your Medicare coverage, both for Part A (hospital) and Part B (medical). 
Deductibles:
Before Medicare begins to pay for services, you'll usually have to pay an annual deductible for Part A and Part B. For example, in 2025, the Part A deductible for hospital stays is $1,676. 
Copays:
These are fixed amounts you pay for specific services, like a doctor's visit or a prescription. For example, you might pay $20 for a doctor's visit or $30 for a prescription. 
Coinsurance:
This is a percentage of the cost you pay for services after you've met your deductible. For example, you might pay 20% of the cost of a hospital stay after you've paid your deductible. 
How they work together:
Pay Premiums: You pay monthly premiums to ensure your Medicare coverage is active.
Meet Deductible: Before Medicare pays for most services, you'll need to meet an annual deductible.
Pay Copays/Coinsurance: After meeting the deductible, you'll pay copays (fixed amounts) or coinsurance (a percentage) for each service. 
In simpler terms:
Think of it like car insurance. You pay a monthly premium to keep your coverage active. If you get in an accident, you pay a deductible before your insurance kicks in to cover the rest of the repair costs. Similarly, with Medicare, you pay monthly premiums, meet a deductible, and then pay copays or coinsurance for your healthcare.

Gary Henderson · Answer

This requires a conversation. Get in touch with me.

Meghan Blankenship · Answer

You are not alone - Medicare costs can feel like a maze, but once you understand how premiums, deductibles, copays and coinsurance fit together, it starts to make sense. Premiums are the monthly fee you pay to have Medicare coverage. Everyone pays a premium for Part B (medical insurance) and sometimes for Part A (hospital insurance) if they didn't work enough years. Deductibles are the amount you pay out of pocket before Medicare starts covering services. You pay it once per year for each part of Medicare.

Answered by Meghan Blankenship on November 13, 2025

Broker Licensed in FL, MD & OH

Answered by Meghan Blankenship Medicare Insurance Agent

Marcie Barnes · Answer

It would be better explained by a licensed professional agent.

My name is Marcie Barnes.  I would be happy to break everything down in simple terms for you

Dean Chiapetto · Answer

Premium is what you pay for an Insurance Policy.
Deductible is what you pay before the insurance company will pay.
Copays are a dollar amount you pay when you use your insurance and CoInsurance is a percentage you pay.

Jack Mayer · Answer

Medicare does have deductibles and co-payments along with coinsurance and when you supplement Medicare but the health plan to take care of all those out of pocket expenses depending on the plan you choose. They are all standardized Plan g is the best other than that you can go with a Medicare Advantage plan and these are network base plans most of them are all HMO and you will have copay and deductibles

Answered by Jack Mayer on September 1, 2025

Agent Licensed in CA & NV

Answered by Jack Mayer Medicare Insurance Agent

Antonio Rodriguez · Answer

Totally understand — Medicare costs can get confusing. Here’s the easiest way to think about it:

• Premiums:
This is your monthly payment just to have the coverage (like Part B or a Part D drug plan).

• Deductibles:
This is what you pay first each year before Medicare or your plan starts paying.

• Copays/Coinsurance:
After your deductible is met, this is your share of the cost for each visit, test, or medication.

Charles Borg · Answer

Ask an agent who knows about Medicare. Don’t rely on what you see on TV or the internet. It always makes sense to go to a professional.

Sam Silva · Answer

Premiums keep your coverage active.

Deductibles are what you pay first before Medicare kicks in.

Copays/coinsurance are your share of the cost after that.

Toni Chavez · Answer

Thanks for your question!

Yes,  this can be very confusing and I’ll simplify it the best I can.

If you have a Medicare Advantage plan (Part C), there’s a max out-of-pocket limit — once you hit it, the plan covers 100% of your approved medical costs for the rest of the year.

What counts toward it: things like copays, coinsurance, deductibles, ER visits, hospital stays, and specialist visits.

What doesn’t count: your monthly premiums, prescription drug costs, or extras like dental and vision.


If you have a PPO plan out of network may have a seperate out of network Max out of pocket.  


Your max out of pocket for prescription drugs for 2025 is $2,000.

Dominic Javier · Answer

The premiums are the periodic payments (monthly, quarterly or annual) the beneficiary pays without fail to maintain an ongoing Medicare plan. The deductibles are the maximum payment the benficiary have to pay initially per benefit period before Medicare benefits starts. And, copay synonymous to coinsurance are additiinal payments you'll have to make usually after enjoying the benefit. These cost components play along with the type of plan you have and will vary based on each amount of the cost element.

Answered by Dominic Javier on April 29, 2025

Broker Licensed in TX

Answered by Dominic Javier Medicare Insurance Agent

Adam Morillo · Answer

Very good question, it all depends which way you go for coverage between Original Medicare and Supplement vs Medicare Advantage. It's best to talk to a licensed agent for a Medicare 101 talk.

William Murray · Answer

Medicare premiums, deductibles & copays work just like the premiums, deductibles & copays of any other health insurance plans you may have or may have had.
There could be differing premium, deductible &/or copay amounts for any of the Parts A, B, C and/or D of Medicare.

Kevin Chaikin · Answer

Premiums are what you pay monthly for policies like Part B, Part C (med Advantage), Part D (Rx), Medigap, and any other ancillary coverage you may add. That is your monthly fixed cost to own the policy. Deductibles are what you pay before the plan pays anything. For instance, on Medicare Part B that is $283 for the year in 2026 and $615 for Part D. Once those deductibles are met, the respective plans start to pay their share. Copays and coinsurance are your cost sharing responsibility after the plan pays. This could be for hospital/medical on Parts A/B or Medicare Advantage as well as Part D and Medigap. Deductibles + Copays + Coinsurance generally add up to your maximum out of pocket if your plan has one. Ultimately, there are so many different combinations of policies and plan types, it is best to review plan specifics to really understand how all these things work and estimate your costs.

Answered by Kevin Chaikin on February 24, 2026

Broker Licensed in VA, AL, AZ & 31 other states

Answered by Kevin Chaikin Medicare Insurance Agent

Fran Lovelace · Answer

There is not a short answer.  You need to have a seasoned medicare agent to share the differences.  You can obtain some information on medicre.gov

Tristan Gibbs · Answer

A premium is essentially what you pay to be enrolled in a plan. A deductible is the portion you must pay before your insurance plan starts to pay their portion. A copayment is an agreed upon amount that you pay in tandem with your insurance provider for a given procedure or medication.

Answered by Tristan Gibbs on April 7, 2026

Broker Licensed in FL

Answered by Tristan Gibbs Medicare Insurance Agent

Aisha Saleem · Answer

Premiums are what you pay for the plan each month. Deductibles are the amount that you're responsible for before you begin paying copay prices. Copays are the fixed amount that is your responsibility to pay for a visit or service.

Answered by Aisha Saleem on June 1, 2025

Agent Licensed in MD & FL

Answered by Aisha Saleem Medicare Insurance Agent

Robert Rowe · Answer

Premiums are the monthly/quarterly/Annual costs for your insurance coverage. Deductibles are the cost amount you typically have to play before receiving full coverage for covered costs. Copays is just what it sounds like it is a cooperated payment between the insured (client) and the insurance for a given medical bill (typically drugs, specialist visits and outpatient surgeries).

Answered by Robert Rowe on May 12, 2025

Broker Licensed in MI

Answered by Robert Rowe Medicare Insurance Agent

Sophia Davis · Answer

Think of it like this... Premium= What you pay monthly in order to have access. Just like you pay monthly to have Netflix or Hulu. Deductible= What you have to pay first. Kind of like when your parents said "If you can save $1,000 towards your first car, we'll help you with the rest (limitations apply)" Copay= A set dollar amount you pay for a certain service. It's like Pay-Per-View. You have the monthly service but some things you just have to pay a little more when you want to use them.

Answered by Sophia Davis on April 16, 2025

Broker Licensed in OH & PA

Answered by Sophia Davis Medicare Insurance Agent

Jacquie Wolf · Answer

Premiums are the monthly cost for whichever plan you choose. 
Deductibles are the amount you have to pay before the plan you enroll in begins to pay. Not all plans have deductibles and not all deductibles apply to all services.
Copays are the dollar amounts you have to pay your providers.
Coinsurance is the percentage you have to pay your providers. This is one or the other, not both.
Examining your needs and budget is the best way to make a choice!

Heather Johnson · Answer

Premiums are the costs per month to have the coverage; similar to the money that was taken out of your paycheck to pay for your coverage in your younger years.

Deductibles are the out-of-pocket expenses that must be met before coverage can begin.

Copays are the amount of money you pay when you visit a provider - be it a doctor, hospital, or pharmacy.

The copays do not count towards the deductible but the remainder of the bill will.  Once the deductible is met, the policy pays the agreed upon percentage.

Marshall Orenic · Answer

Great question! That is why it is important to take the time to allow a trained and licensed agent walk you through the process and explain each part in detail.

John Ward · Answer

Premium are membership fees, thatt is what you pay every month just to have Medicare coverage, many plans do not have a premium. Deductibles is the cost that must be paid prior to Medicare starts paying for most covered services. Co-pays are basically a fixed payment for a covered service.

Answered by John Ward on August 12, 2025

Broker Licensed in TX, FL, GA, LA, NM & OK

Answered by John Ward Medicare Insurance Agent

Christine Itami · Answer

This question is multi-faceted and is difficult to answer without speaking to the person and know their particular situation. One must evaluate the needs of the client before trying to explain costs, deductibles, and copays without talking about plan selection. I won't go into much detail, but if someone wants to meet or talk by phone I would be happy to review the answers to all of these questions after I do a needs analysis.

Answered by Christine Itami on May 19, 2025

Broker Licensed in AZ, FL, ID & 5 other states

Answered by Christine Itami Medicare Insurance Agent

I'm confused about all these different Medicare costs - premiums, deductibles, copays. How do they all work together?

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