2025 MEDICARE & SOCIAL SECURITY CHEAT SHEET

Great Oak Insurance Solutions | (951) 319-3545 | www.greatoakis.com

Medicare Costs 2025

Part A (Hospital Insurance)

Monthly Premium

$0

For most people

Deductible$1,676 per benefit period

Cost Sharing:

  • • Days 1-60: $0 coinsurance
  • • Days 61-90: $419/day
  • • Days 91+: $838/day (lifetime reserve days, max 60 days)
Part B (Medical Insurance)

Monthly Premium

$185

Standard amount

Annual Deductible$257

Cost Sharing

Medicare pays 80%, you pay 20%

⚠️ No limit on total out-of-pocket costs!

Medicare IRMAA Chart 2025

Income-Related Monthly Adjustment Amount

Higher income means higher Medicare premiums

Individual Income (2023)

$106,000 or less

Joint Income (2023)

$212,000 or less

Part B Premium

$185.00

Part D IRMAA

---

Individual Income (2023)

$106,001 - $133,000

Joint Income (2023)

$212,001 - $266,000

Part B Premium

$259.00

Part D IRMAA

+ $13.70

Individual Income (2023)

$133,001 - $167,000

Joint Income (2023)

$266,001 - $334,000

Part B Premium

$370.00

Part D IRMAA

+ $35.30

Individual Income (2023)

$167,001 - $200,000

Joint Income (2023)

$334,001 - $400,000

Part B Premium

$480.90

Part D IRMAA

+ $57.00

Individual Income (2023)

$200,001 - $499,999

Joint Income (2023)

$400,001 - $749,999

Part B Premium

$591.90

Part D IRMAA

+ $78.60

Individual Income (2023)

$500,000 +

Joint Income (2023)

$750,000 +

Part B Premium

$628.90

Part D IRMAA

+ $85.80

Medicare Enrollment Periods

Initial Enrollment Period

Your 7-month window around turning 65

  • • 3 months before your birthday month
  • • Your birthday month
  • • 3 months after your birthday month

Important: Your Medicare typically starts on the 1st day of the month you turn 65 (unless you delay it due to having other coverage). This is your time to get a Supplement without health questions!

Annual Election Period (AEP)

October 15 - December 7

During AEP, you can enroll in Advantage & Part D Drug plans for 2026

Changes take effect January 1st of the following year

Open Enrollment Period (OEP)

January 1 - March 31

During OEP, you can make one change to your Medicare Advantage plan

Only available if you're already enrolled in Medicare Advantage

Medicare Supplement (Medigap)

All Year

You can enroll in a Medicare Supplement (Medigap) plan at any point in the year

*Must pass medical underwriting (except during your Initial Enrollment Period)

Special Election Periods (SEP)

Certain events allow you to make changes to your coverage outside of the enrollment periods listed.

Common SEPs include:

  • • Moving to a new service area
  • • Losing other health coverage
  • • Getting or losing Medicaid benefits
  • • Entering or leaving a skilled nursing facility
  • • Plan leaving your service area

Social Security Full Retirement Age

Survivor Benefits
Birth YearFull Retirement Age
1945 - 195666
195766 and 2 months
195866 and 4 months
195966 and 6 months
196066 and 8 months
196166 and 10 months
1962 and Later67
All Other Benefits
Birth YearFull Retirement Age
1943 - 195466
195566 and 2 months
195666 and 4 months
195766 and 6 months
195866 and 8 months
195966 and 10 months
1960 and Later67

Spousal Benefit Formula

(1/2 of higher earner FRA benefit)

(lower earner FRA benefit)

=

spousal payment

(then adjusted for filing age)

Social Security: Age-Based Reductions & Increases

Benefit Percentage by Filing Age

Note: Assuming a Full Retirement Age of 67

Filing AgeIndividual Benefit % of FRASpousal Benefit % of Earner's FRASurvivor Benefit % of Benefit
60N/AN/A71.50%
61N/AN/A75.58%
6270%65%79.65%
6375%70%83.72%
6480%75%87.79%
6586.66%83.33%91.86%
6693.33%91.66%95.93%
67100%100%100%
68108%100%100%
69116%100%100%
70124%100%100%

Key Insight: Delaying your own retirement benefit until age 70 increases it by 24% compared to claiming at full retirement age (67).

Social Security Earnings Limit 2025

Earnings Test

Age 62 - Before Full Retirement Age

$23,400

$1 withheld for every $2 over limit

Year Reaching Full Retirement Age

$62,160

$1 withheld for every $3 over limit

Full Retirement Age and Beyond

No Limit

Earn as much as you want!

What Counts as "Earnings"?

DOES COUNT

  • • Wages from employment
  • • Net earnings from self-employment

DOES NOT COUNT

  • • Pension payments
  • • Annuity payments
  • • IRA distributions
  • • Dividends & interest income
  • • Capital gains

Monthly Reductions / Increases

Individual Benefits
(-) 5/9 of 1%36 month period before full retirement age
(-) 5/12 of 1%More than 36 months before full retirement age
(+) 2/3 of 1%Full Retirement Age to Age 70
Spousal Benefits
(-) 25/36 of 1%36 month period before full retirement age
(-) 5/12 of 1%More than 36 months before full retirement age
No increase beyond full retirement age

Survivor Benefits

28.5% is maximum reduction regardless of full retirement age. To determine the monthly amount of reduction based on various full retirement ages, divide the number of months between age 60 and full retirement age by 28.5

Tax on Social Security

Step 1: Calculate Combined Income
Adjusted gross income
+ Tax Exempt Income
+ Exclude Foreign Income
+ 50% of SS Benefit
= Combined Income
Step 2: Apply to Thresholds
Single ReturnJoint Return% Taxed
$0 - $24,999$0 - $31,999$0
$25,000 - $34,000$32,000 - $44,000Up to 50%
Over $34,000Over $44,000Up to 85%

Maximum % of YOUR Full Retirement Age Benefit

An eligible family member can receive if you:

DIERETIRE (OR) BECOME DISABLEDAGE-BASED CONSIDERATIONS
SPOUSAL BENEFIT100%
(Adjusted for survivor's filing age)
50%
(Adjusted for survivor's filing age)

If you retire or become disabled, your spouse can collect at age 62+ or any age if caring for your child who is under 16 or disabled before the age of 22

If you die, your spouse of any age who is caring for your child who is under 16 or child of any age if child was disabled before 22

CHILD IN CARE BENEFIT75%50%Payable to spouse of any age who is caring for your child who is under 16 or child of any age if child was disabled before 22
BENEFIT TO CHILDREN75%50%Payable to child who is under 18, or 19 if still in high school of any age if disabled before 22

Additional Requirements

Length of Marriage Rules
9 MonthsSurvivor Benefits
1 YearSpousal Benefits
10 YearsDivorced Spouse
Social Security Disability Thresholds

SUBSTANTIAL GAINFUL ACTIVITY

Non-Blind$1,620/month
Blind$2,700/month
Trial Work Period$1,160/month

Quick Reference Stats

Average Social Security Benefit

$1,976

All Retirees

Couple (Both Receiving Benefits)

$3,089

Combined Monthly

Average Disability Benefit

$1,580

SSDI Recipients

Quarter of Coverage (2025)

$1,810

Per Credit

Maximum Taxable Wages

$176,100

Social Security Tax Cap

Social Security Administration

1-800-772-1213

Official Helpline

Important Disclaimer

This guide is meant to be for general information. Please don't rely solely on the information contained herein when making decisions about Medicare or Social Security.

Always consult with Medicare.gov, 1-800-MEDICARE, the Social Security Administration (1-800-772-1213), or your local State Health Insurance Program (SHIP) for official guidance.

Multiple exceptions exist for many Medicare and Social Security rules. Individual circumstances vary, and this guide provides general information only.

Need Help Understanding Your Options?

Our experienced agents can help you navigate Medicare and maximize your Social Security benefits