Free Medicare Educational Resource • Printable Worksheet

Organize the Medicare Costs That May Affect the Whole Household

Use this worksheet to identify cost categories that may matter to your household and create one place to record questions, estimates, and items that need current verification.

Medicare Household Cost Planning Worksheet is a free educational resource accompanying Medicare: I Get It Now!.

Independent educational resource. Not affiliated with or endorsed by Medicare or any government agency.

Medicare Household Cost Planning Worksheet
Premium categories
Prescription expenses
Medical-service expenses
Dental expenses
What’s Inside

Use one place to organize the information this resource covers.

The printable worksheet includes space or reference material for the following topics:

Premium categories
Prescription expenses
Medical-service expenses
Dental expenses
Vision expenses
Hearing expenses
Transportation
Caregiver expenses
Travel-related considerations
Emergency reserve
Spouse or partner expenses
Annual review section
Keep in mind: The worksheet intentionally does not publish current annual Medicare dollar amounts. Verify current figures through the appropriate official source.
Free Resource Request

Get the Medicare Household Cost Planning Worksheet

Enter the email address where you want the resource sent.

Please do not enter or send sensitive personal information.
Do not provide Medicare numbers, Social Security numbers, health information, banking information, credit-card information, or other sensitive personal information through this resource-request form.
Educational and non-affiliation notice: This resource and website provide general educational information. They are independently published and are not affiliated with or endorsed by Medicare, CMS, HHS, SSA, HealthCare.gov, the Marketplace, or any government agency. Medicare rules, costs, dates, programs, and guidance may change; verify current information through appropriate official sources.