Medicare Explained 2025: Plans, Costs, and How to Enroll

Medicare is a crucial health insurance program for millions of Americans aged 65+ and those with disabilities. But with different parts, enrollment periods, and plan options, many people find it overwhelming. 

In this guide, we’ll break down:

1. Medicare Parts A, B, C, and D

2. Costs for 2025

3. Key enrollment deadlines

4. How to pick the best plan

Let’s dive in!

What is Medicare?

Medicare is a federal health insurance program primarily for:

• People 65+

• Younger individuals with disabilities

• Those with End-Stage Renal Disease (ESRD)

It has four main parts:

• Part A (Hospital Insurance)- Inpatient hospital stays, skilled nursing, hospice

• Part B (Medical Insurance)- Doctor visits, preventive care, outpatient services

• Part C (Medicare Advantage)- Private alternative to Original Medicare (A+B), often includes Part D

• Part D (Prescription Drugs)- Covers medications

Medicare Costs in 2024

Medicare Part A Costs

• Premium: $0 for most (if you paid Medicare taxes for 10+ years)

• Deductible: $1,632 per benefit period (hospital stays)

Medicare Part B Costs

• Standard Premium: $174.70/month (may be higher based on income)

• Annual Deductible: $240

Medicare Advantage (Part C) Costs

Average Premium: ~$18/month (varies by plan)

Out-of-pocket max: Up to $8,850 (in-network)

Medicare Part D Costs

Average Premium: ~$34/month

Deductible: Up to $545 (plan-dependent)

When Can You Enroll in Medicare?

Missing deadlines can lead to late penalties! Key enrollment periods:

1. Initial Enrollment Period (IEP): For new Medicare beneficiaries

   Dates- 7 months (3 before + month of + 3 after 65th birthday)

2. General Enrollment (Jan 1 – Mar 31): Late enrollees

   Dates- If you missed IEP (coverage starts July 1)

3. Annual Enrollment (Oct 15 – Dec 7): Current Medicare users

   Change Medicare Advantage or Part D plans

4. Special Enrollment Period (SEP): Qualifying life events

   Varies (job loss, moving, etc.)

Medicare Advantage vs. Original Medicare

Original Medicare (Parts A + B)

Flexibility- See any doctor who accepts Medicare

No cap on out-of-pocket costs

No dental/vision coverage

Medicare Advantage (Part C)

Extra benefits (dental, vision, gym memberships)

Out-of-pocket max (financial protection)

Network restrictions (like an HMO/PPO)

Which is better? Depends on your health needs and budget!

How to Choose the Best Medicare Plan

1. Check if your doctors accept Medicare/Medicare Advantage

2. Compare drug coverage (Part D) if you take medications

3. Review extra benefits (dental, hearing, etc.)

4. Estimate total costs (premiums + deductibles + copays)

Common Medicare Mistakes to Avoid

Missing enrollment deadlines → Lifetime penalties

Assuming Medicare covers everything (no long-term care, most dental)

Not reviewing your plan annually (benefits change yearly!)

Medicare can be complex, but understanding the parts, costs, and enrollment rules helps you make the best choice.

Need personalized help? Call us today! 503-757-7121