Medicare Calculator
Calculate your Medicare costs including Part A, B, C, D premiums, IRMAA surcharges, and supplemental coverage. Plan your healthcare budget for retirement.
Your tax filing status affects IRMAA surcharges
From 2 years ago (2024 premiums use 2022 income). Check tax return line 11.
Year for which you are calculating Medicare costs
Part B covers doctor visits, outpatient care. Most people enroll.
Part D covers prescription drugs. Highly recommended to avoid penalties.
Average plan $25-$50/month. Check Medicare.gov for specific plans.
Supplemental plans cover gaps in Original Medicare
If selected Medigap. Average $100-$300/month depending on plan and age.
If selected Advantage. Many $0 premium plans available.
What are the different parts of Medicare?
Part A (Hospital Insurance): Covers inpatient hospital stays, skilled nursing, hospice. FREE for most with 40+ work quarters. Part B (Medical Insurance): Covers doctor visits, outpatient care, preventive services. $174.70/month standard (2024). Part C (Medicare Advantage): Private insurance alternative to Original Medicare (A+B), often includes drug coverage. Part D (Prescription Drug Coverage): Covers medications. $35-50/month average. Medigap: Private supplement to cover gaps in Original Medicare.
What is IRMAA and who pays it?
IRMAA (Income-Related Monthly Adjustment Amount) is a surcharge on Part B and Part D for higher-income beneficiaries. Based on MAGI from 2 years prior (2024 premiums use 2022 income). 2024 thresholds: Individual $103k+, Joint $206k+. Surcharges range from $69.90-$419.30/month for Part B and $12.90-$81/month for Part D. If income drops, you can appeal for reduction. Use tax return line 11 for MAGI.
When should I enroll in Medicare?
Initial Enrollment Period: 3 months before your 65th birthday month, your birthday month, and 3 months after (7-month window). Late enrollment penalties: 10% per year for Part B if you delay without creditable coverage. 1% per month for Part D if delayed. Exceptions: If you have employer coverage (20+ employees), you can delay without penalty. Enroll during Special Enrollment Period when employer coverage ends. Missing your window can be costly!
Should I choose Original Medicare or Medicare Advantage?
Original Medicare (A+B): Go to any doctor/hospital accepting Medicare nationwide. Need to add Part D separately. Consider Medigap for gap coverage. More freedom, higher out-of-pocket. Medicare Advantage (Part C): Private plan (HMO/PPO). Often $0 premium, includes drug coverage. Network restrictions, need referrals. Lower premiums, predictable costs. Best choice depends on: health status, budget, travel needs, preferred doctors. You can switch during Annual Enrollment (Oct 15-Dec 7).
What does Medicare Part A cover?
Part A covers: (1) Inpatient hospital stays (semi-private room, meals, nursing), (2) Skilled nursing facility care (after 3-day hospital stay, up to 100 days), (3) Hospice care for terminal illness, (4) Home health services (part-time nursing, therapy). What it does NOT cover: Long-term care/nursing home, custodial care, private room (unless medically necessary). 2024 deductible: $1,632 per benefit period. Days 61-90: $408/day copay. Days 91+: $816/day (60 lifetime reserve days).
What does Medicare Part B cover?
Part B covers: (1) Doctor visits and outpatient care, (2) Preventive services (vaccines, screenings, annual wellness), (3) Ambulance services, (4) Durable medical equipment (wheelchairs, walkers), (5) Mental health (outpatient), (6) Lab tests and X-rays. What it does NOT cover: Dental, vision, hearing aids, long-term care. 2024 premium: $174.70/month standard. Deductible: $240/year. Then you pay 20% coinsurance (no out-of-pocket maximum without supplement).
What is Medigap and do I need it?
Medigap (Medicare Supplement Insurance) is private insurance that covers gaps in Original Medicare: 20% coinsurance, deductibles, copays. Plans A-N available with standardized benefits. Best time to buy: 6-month open enrollment starting when you turn 65 AND enroll in Part B (guaranteed issue, no health questions). After that, insurers can deny or charge more for pre-existing conditions. Cost: $100-300/month depending on plan, age, location. Consider if: you want predictable costs, travel frequently, have chronic conditions.
Can I have employer insurance and Medicare together?
Yes, and coordination depends on employer size: Large employer (20+ employees): Employer is primary, Medicare is secondary. You can delay Part B enrollment without penalty. Small employer (<20 employees): Medicare is primary, employer is secondary. You should enroll in Part B at 65 to avoid gaps and penalties. When you retire: Use Special Enrollment Period to sign up for Medicare without penalty (8-month window after coverage ends). Important: Notify Medicare which is primary to avoid claim issues.
What is the Medicare Part D donut hole?
The "donut hole" (coverage gap) occurs when you and your plan have spent a certain amount on drugs ($5,030 in 2024). In the gap, you pay: 25% for brand-name drugs, 25% for generics (manufacturers provide 70% discount on brand names). Once you spend $8,000 out-of-pocket (2024), you enter catastrophic coverage and pay only $4.15/generic or $10.35/brand or 5%, whichever is greater. The gap has shrunk significantly since 2010 and will continue closing.
Can I change my Medicare coverage after initial enrollment?
Yes! Annual Enrollment Period (AEP): October 15 - December 7 each year. Switch between Original Medicare and Medicare Advantage, change Part D plans, add/drop Medigap (subject to underwriting after initial period). Medicare Advantage Open Enrollment: January 1 - March 31 (switch to different Advantage plan or return to Original Medicare). Special Enrollment Periods: Triggered by moving, losing other coverage, qualifying for extra help, etc. Changes take effect January 1 (for AEP) or as specified for special periods.