What You Pay for Medicare Depends on Which Parts You Have
Medicare has four parts — A, B, C, and D — and each one costs money in a different way. Part A (hospital insurance) is usually free if you or your spouse paid Medicare taxes for at least 10 years while working. Part B (doctor visits and outpatient care) costs a monthly premium that comes out of your Social Security check or is billed to you directly. Part C (Medicare Advantage) and Part D (prescription drugs) are sold by private insurance companies and have their own premiums, deductibles, and copays.
Most people pay for Medicare through a combination of monthly premiums, yearly deductibles, and per-visit copays or coinsurance. The exact amount depends on your income, which parts you choose, and which insurance company you pick. There is no single bill — instead, costs come from different sources and hit your wallet at different times.
Key Takeaways
- Part A is usually free; Part B premiums are deducted from your Social Security payment or billed separately each month.
- Your Part B premium amount depends on your income from two years ago, and higher earners pay a larger share.
- Part C (Medicare Advantage) and Part D (prescription drugs) are optional and sold by private insurers with their own monthly costs.
- You can change your coverage choices during the annual enrollment period (October 15 to December 7) or if you have a may have access to life event.
- If you cannot afford premiums, you may be able to get help through Medicaid, the Medicare Savings Program, or other state programs.
Part A and Part B Premiums: How Much and When They Are Due
Part A has no monthly premium for most people because you earned it through payroll taxes. However, if you did not work long enough to may have access to for free Part A, you can buy it for roughly $278 to $505 per month in 2024, depending on how many years you worked. The Social Security Administration will tell you whether you may have access to for free Part A when you first sign up for Medicare.
Part B costs a standard monthly premium — $164.90 per month in 2024 for most people — but the amount you actually pay depends on your income from two years prior. If your modified adjusted gross income (MAGI) was above a certain threshold, you pay an Income-Related Monthly Adjustment Amount (IRMAA), which is an extra charge on top of the standard premium. For example, a single person with a MAGI above $97,000 in 2022 would pay more for Part B in 2024. The higher your income, the higher your premium.
Part B premiums are normally taken directly from your Social Security check each month. If you do not receive Social Security, Medicare bills you by mail. You must pay by the important date shown on your bill, or your coverage can be delayed or cancelled.
Part C (Medicare Advantage) and Part D (Prescription Drug) Costs
Part C plans are sold by private insurance companies like UnitedHealthcare, Humana, and Aetna. These plans bundle hospital, doctor, and prescription drug coverage into one policy and often cost less in monthly premiums than Original Medicare plus a separate drug plan — some have zero monthly premium. However, you typically pay more when you use care: higher copays for doctor visits, stricter networks (you may have to use in-network doctors), and prior authorization requirements for certain treatments.
Part D is prescription drug coverage sold separately by private insurers. If you have Original Medicare (Part A and B), you must buy Part D or pay a penalty if you go without it for more than 63 days. Part D premiums vary by plan and company — they can range from roughly $7 to $100+ per month — and you also pay a yearly deductible (usually $505 in 2024) before the plan starts covering drugs. After that, you pay copays or coinsurance for each prescription.
Both Part C and Part D premiums are billed separately from your Social Security check. The insurance company sends you a bill each month, or you can set up automatic payments from your bank account.
Deductibles, Copays, and Coinsurance: What You Pay at the Doctor
Beyond premiums, you pay out-of-pocket costs when you use care. Part A has a deductible of $1,632 per hospital stay in 2024 — you pay this amount before Medicare starts paying. Part B has a yearly deductible of $240 in 2024; after you meet it, you typically pay 20% coinsurance for most services while Medicare pays 80%.
Part C plans set their own deductibles and copays, which vary widely by plan. Some plans have zero deductible and low copays ($10 to $50 per doctor visit), while others have higher deductibles and copays. You need to compare the plans available in your area to see which costs fit your budget.
Part D has a yearly deductible (usually $505 in 2024) and then a coverage gap called the "donut hole." Once you and your plan have spent $5,850 combined on drugs in 2024, you enter the donut hole and pay 25% of drug costs until you reach $7,550 in out-of-pocket spending. After that, catastrophic coverage kicks in and you pay only a small copay per prescription for the rest of the year.
How Income Affects What You Pay
Your income from two years ago determines your Part B and Part D premiums through the IRMAA system. Medicare uses your tax return to calculate your modified adjusted gross income (MAGI), which includes wages, interest, dividends, and some retirement distributions. If your income is higher, you pay a higher share of the cost.
The income brackets change each year. In 2024, a single person with a MAGI above $97,000 pays extra for Part B; a married couple filing jointly with a MAGI above $194,000 pays extra. Part D has similar thresholds. If your income drops — because you retire, take a loss, or have a major life change — you can ask Medicare to recalculate your premium based on your current year income instead of the prior year.
Payment Methods and Billing
Part B premiums are deducted automatically from your Social Security check if you receive one. If you do not get Social Security, Medicare sends you a bill by mail each month, and you can pay by check, money order, or online through the Medicare website.
Part C and Part D premiums are billed by the insurance company, not by Medicare. You receive a separate bill from your plan each month. Most companies let you pay online, by phone, or by automatic bank transfer. Some plans also let you pay by mail with a check.
If you miss a payment, your coverage can be suspended or cancelled. Contact your plan when ready if you cannot pay on time — some plans have hardship programs or payment plans for people facing financial difficulty.
Getting Help Paying for Medicare
If your income is low, you may be able to get help paying premiums and out-of-pocket costs through Medicaid, the Medicare Savings Program (MSP), or the Low-Income Subsidy (LIS) program for Part D drugs. These programs are run by your state, not by Medicare, and income limits vary by state.
The Medicare Savings Program helps pay your Part B premium, deductible, and coinsurance if your income is below roughly 135% to 200% of the federal poverty level (the exact threshold depends on your state). The Low-Income Subsidy program helps pay Part D premiums and out-of-pocket drug costs if your income is below 150% of the federal poverty level.
To find out whether you may have access to, contact your state Medicaid office or call 1-800-MEDICARE. You can also visit your local Area Agency on Aging, which can help you fill out the paperwork. Processing can take several weeks, so explore as soon as you think you might may have access to.
Changing Your Coverage and Enrollment Periods
You can change your Part C or Part D plan once per year during the Annual Enrollment Period, which runs from October 15 to December 7. Changes take effect on January 1 of the following year. If you miss this window, you cannot switch plans until the next year — unless you have a may have access to life event like moving, losing employer coverage, or a death in the family.
If you have a may have access to event, you have 60 days to make changes. Contact Medicare or your plan to report the event and request a Special Enrollment Period. Without this documentation, your request will be denied.
You cannot change from Original Medicare (Part A and B) to Part C during the Annual Enrollment Period — that change happens during the Initial Enrollment Period when you first turn 65, or during the General Enrollment Period (January 1 to March 31) if you missed your initial window. Changing back from Part C to Original Medicare is possible during the Annual Enrollment Period, but you should do it carefully because you may face a gap in coverage if you do not also enroll in Part D.
Frequently Asked Questions
What happens if I do not pay my Medicare premium on time?
Your coverage can be suspended or cancelled if you miss a payment. For Part B, Social Security will stop deducting the premium from your check. For Part C and Part D, your plan may terminate your coverage. Contact your plan or Medicare when ready if you cannot pay — some plans offer payment arrangements or hardship programs.
Can I get a refund if I overpay my Medicare premium?
Yes. If you overpay Part B, Medicare will refund the difference or credit it toward future premiums. For Part C and Part D, contact your insurance company directly. Refunds can take several weeks to process.
Do I have to pay for Part A if I worked but did not pay Medicare taxes?
If you worked but were not covered by Medicare taxes — for example, some government employees — you may not may have access to for free Part A. You can buy Part A for roughly $278 to $505 per month. Contact Social Security to find out your status before you turn 65.
What if my income changes after I sign up for Medicare?
If your income drops significantly — because you retire, take a loss, or have a major life event — you can ask Medicare to recalculate your IRMAA based on your current year income instead of the prior year. You must report the change within 60 days and provide proof, such as a recent tax return or a letter from your employer.
Can I use a credit card to pay my Medicare premium?
For Part B, you can pay online through the Medicare website using a debit or credit card. For Part C and Part D, check with your insurance company — some accept credit cards online or by phone, while others accept only checks or bank transfers.