How can I estimate my total medical costs with a Medicare plan?

Who is this for?

Learn how to choose the right plan.

If you're shopping for a Medicare plan, this will help you understand how to calculate your out-of-pocket costs.

There’s a lot to consider when you’re shopping for a Medicare plan. But the question at the top of your list is probably “What is this going to cost me?”

When you're shopping, you'll see the monthly premium, or monthly payment, front and center. But it's important to remember that it's not your only cost. You'll also have to pay when you go to the doctor or get prescription drugs.

How to calculate your total monthly costs

It’s easy to calculate your fixed costs each month. You'll be able to see your plan's monthly premium before you sign up.

You’ll also need to pay your Medicare Part B premium each month. You can find out how much that costs at

Your other costs will depend on how much you see the doctor and how many prescription drugs you take. Basically, how much you get health care. This is where you'll want to compare copays, coinsurance and deductibles for each plan you're looking at.

Here's an exercise you can go through to estimate your monthly medical costs:

Fixed costs: Your plan's monthly premium and your Medicare Part B monthly premium +

Doctor costs: The number of times you go to the doctor each month multiplied by your plan's copay +

Prescription costs: The prescription drugs you take each month multiplied by your plan's copay =

Your total monthly costs

Finding the right balance

Here's a good rule of thumb when you're shopping for a plan: a higher monthly premium means lower copays, coinsurance and deductible.

So you can pay more each month and pay less when you get care. Or you can pay less each month and pay more when you go to the doctor or pharmacy.

Here are some other things to think about in terms of cost when you're shopping for a plan:

  • Copays and coinsurance: If you see the doctor a lot, you'll want to look for a plan that has lower copays and coinsurance. But if you're relatively healthy, you might be able choose a plan with higher copays and still keep your costs low.
  • Prescription costs: You'll want to think about how many drugs you take, how much they cost and whether the plan you're looking at covers them. You can use the plan's drug list to see what drugs it covers and what drug tier your drug is in. Drug tiers determine how much the plan will pay toward a certain drug.
  • Deductible: Most of our Medicare plans have a relatively low deductible, or even no deductible. But generally speaking, if you see the doctor a lot, you'll want a plan with a low deductible. That's because you pay in full for most health services before you meet your deductible.