5 Health Care Costs Medicare Doesn’t Cover

If you're like many Medicare beneficiaries, you're concerned about Medicare out-of-pocket costs.

Out-of-pocket Medicare costs include deductibles, co-insurance, co-payments, and excess charges — which can add up to thousands of dollars a year.

Below are 5 health care costs uncovered by Medicare and how a Medicare Supplement insurance policy can help you avoid paying them.

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1. Deductibles

There are deductibles for Medicare Parts A and B that you must meet before coverage kicks in:

• $1,676 Part A deductible per benefit period in 2025
• $257 Part B annual deductible in 2025

9 of the 10 standardized Medigap plan options include some coverage for the Part A deductible. Only Medigap Plans C and F cover the Part B deductible. 

Important: Plan F and Plan C are not available to beneficiaries who became eligible for Medicare on or after January 1, 2020.

2. Co-insurance and co-payments

Co-insurance and co-payments are fixed percentages or dollar amounts that you must pay out of pocket in order to get a medical service covered. You may have to pay co-insurance and co-payments for several Part A and Part B services. Here are a few:

Part A hospital care

You may have to pay the following in 2025 to use your Part A hospital care coverage:

• $419 per day for days 61-90 in each benefit period
• $838 per day for days 91+ in each benefit period (lifetime reserve days available)
• All costs for days 91+ in each benefit period (no lifetime reserve days available)

All of the nationally standardized Medigap plans include coverage for the Part A hospital care co-insurance.

Medicare Part B services

You have to pay co-insurance to get routine medical care covered through Medicare Part B.

In 2025, you must pay 20% of the Medicare-approved amount for most covered medical services. So if a procedure covered by Part B costs $1,000, you may have to pay $200 out of pocket.

All of the nationally standardized Medigap plans include some coverage for this cost.

Part A skilled nursing care

You may have to pay the following in 2025 to use your Part A skilled nursing care coverage:

• $209.50 per day for days 21-100 in each benefit period
• All costs for days 101+ in each benefit period

Medigap Plans C, D, F, G, M, and N provide full coverage for the Part A skilled nursing care co-insurance. Plan K and Plan L provide partial coverage.

3. First 3 pints of blood

If you need a blood transfusion, Medicare covers the cost only for the 4th pint and beyond.

You may need to pay the entire cost of the first 3 pints of blood for a transfusion.

All of the nationally standardized Medigap plans provide full or partial coverage for the cost of the first 3 pints of blood.

4. Excess charges

If your medical provider or facility does not accept Medicare assignment, you may face excess charges.

You may have to pay up to 15% of the Medicare-approved amount for a service in 2025 if your doctor does not accept Medicare assignment.

Medigap Plans F and G provide full coverage for excess charges.

5. Foreign travel emergency

Medicare only covers foreign emergency health care in a small set of rare situations.

You may have to pay all costs for any non-approved emergency care outside of the United States.

Medigap Plans C, D, F, G, M, and N pay for 80% of the cost of certain medically necessary foreign travel emergency care.