However, even with the added flexibility that Medicare Advantage plans provide, you may still be responsible for out-of-pocket costs, including copays.
A Medicare copay is the amount of money you're required to pay for a covered Medicare service or good. A copayment is typically a flat fee.
Learn More About Medicare
Join our email series to receive your free Medicare guide and the latest information about Medicare and Medicare Advantage.
By clicking "Sign me up!” you are agreeing to receive emails from MedicareAdvantage.com.
What are 2024 Medicare copay amounts?
Private Medicare plans like Medicare Advantage plans and Part D prescription drug plans may include their own copay and deductible amounts that can vary from one plan to the next.
Original Medicare (Part A and Part B) has fixed copay amounts:
Medicare Part A inpatient hospital copay If you experience a hospital stay that lasts longer than 60 days, you're responsible for a $408 Part A copay per day for each additional day up to day 90. This is after you meet your Part A deductible for the benefit period, which is $1,632 in 2024.
If your hospital stay lasts longer than 90 days, you'll pay an $816 copay per day for up to 60 lifetime reserve days.
Medicare Part A skilled nursing facility copay In 2024, you'll pay a copay of $204 per day if you have an inpatient skilled nursing facility stay that lasts longer than 20 days.
Medicare Part B copay After you meet your annual Part B deductible, you'll typically pay a 20% Medicare copay for covered medical services and devices through the rest of the year.
Why Medicare Advantage?
More than 30 million Medicare beneficiaries are enrolled in a Medicare Advantage plan. This equals nearly half the total population of Medicare-eligible Americans.1
Many are likely drawn to the unique benefits of Medicare Advantage plans as compared with Original Medicare:
Medicare Advantage plans may often include benefits not covered by Original Medicare.
The average premium for a 2024 Medicare Advantage plan is $13.24 per month.2 Some plans may not have a monthly premium, and some may even help pay you back for your Medicare Part B premium.
Medicare Advantage, unlike Original Medicare, comes with an out-of-pocket limit, which means your out-of-pocket spending will be capped.
While plans are offered by private insurers, you are still guaranteed the benefits of Original Medicare.
Medicare Advantage costs
Medicare Advantage out-of-pocket costs can include:
Medicare Part B premium Even under Medicare Advantage, you must still pay your Part B premium (unless your plan helps pay for it). The standard Part B premium in 2024 is $174.70 per month.
Deductibles Some plans require you to meet a deductible when seeing doctors, visiting hospitals, or getting your drugs filled.
Medicare copay Many Medicare Advantage plans require that you pay a copay when you see a doctor. This is a fixed cost — and an alternative to Original Medicare’s 20 percent coinsurance.
Premiums As noted above, the average monthly premium for 2024 Medicare Advantage plans with drug coverage is $13.24 per month.
Note: these costs may be higher (or lower), depending on your plan.
Compare Medicare plan costs
As you compare your options, you should weigh Medicare Part C costs against the additional benefits you may receive, as compared to staying with Original Medicare.
Christian Worstell is a senior Medicare and health insurance writer with MedicareAdvantage.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.
Christian’s work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.
Christian has written hundreds of articles for MedicareAvantage.com that teach Medicare beneficiaries the best practices for navigating Medicare. His articles are read by thousands of older Americans each month. By better understanding their health care coverage, readers may hopefully learn how to limit their out-of-pocket Medicare spending and access quality medical care.
Christian’s passion for his role stems from his desire to make a difference in the senior community. He strongly believes that the more beneficiaries know about their Medicare coverage, the better their overall health and wellness is as a result.
A current resident of Raleigh, Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism.
If you’re a member of the media looking to connect with Christian, please don’t hesitate to email our public relations team at Mike@tzhealthmedia.com.
2 TZ Insurance Solutions analysis of data provided by the Centers for Medicare & Medicaid Services (CMS), including the 2024 MA Landscape Source Files as well as carrier-provided plan data provided by Sun Fire Inc.
If your Medicare card is lost, stolen or damaged, you can get a replacement card from Social Security and the Railroad Retirement Board, or by calling Medicare or logging into your My Social Security online account. Read more
Medicare beneficiaries who are also eligible for Medicaid are considered dual eligible. If you are Medicare dual eligible, you may qualify for a Medicare D-SNP (Dual Special Needs Plan), which is a type of Medicare Advantage plan. D-SNP plans are not available in all states. Read more