Medicare premiums vary by the type of coverage you choose and your income
Medicare Part A (hospital insurance) has no monthly premium for most people who paid Medicare taxes while working. Medicare Part B (medical insurance) costs $164.90 per month in 2024 for most people, though you pay more if your income was above a certain level two years ago. Medicare Part D (prescription drug coverage) premiums depend on which plan you pick — they range widely, from around $7 to $100+ per month. Medicare Advantage plans (Part C) often have no premium or a low one, but you still pay Part B and may pay Part D separately.
Your actual cost also depends on whether you have other insurance, when you signed up, and whether you may have access to for help paying premiums. Income-related adjustments can raise your Part B and Part D costs significantly if you earned more than roughly $97,000 as an individual in 2022 (the income year used for 2024 premiums).
Key Takeaways
- Part A has no premium for most people; Part B costs $164.90 monthly in 2024 for standard enrollees.
- Part D premiums vary by plan and range from under $10 to over $100 per month depending on the drugs you need.
- Medicare Advantage plans may have $0 or low premiums but require you to use their network and still pay Part B.
- If your income was above roughly $97,000 in 2022, you will pay a higher Part B and Part D premium starting in 2024.
- You can reduce premiums through programs like Extra Help (for Part D) or Medicaid if your income is low enough.
Part A and Part B premiums: what most people pay
Part A covers hospital stays, skilled nursing care, hospice, and home health. Most people who worked and paid Medicare taxes for at least 10 years pay nothing for Part A. If you did not work that long, you may pay up to $505 per month in 2024. Your spouse's work history can also count, so ask if you are unsure.
Part B covers doctor visits, outpatient care, lab work, and some equipment. The standard monthly premium is $164.90 in 2024. You also pay a yearly deductible of $240 before Part B starts to pay, and then you typically pay 20% of the cost after that. If you delayed signing up for Part B and do not have other coverage, you may pay a permanent penalty of 10% extra for each year you were late.
Both Part A and Part B premiums are deducted from your Social Security check automatically if you receive benefits. If you do not yet receive Social Security, Medicare bills you directly.
Income-related adjustments: when you pay more
If your modified adjusted gross income (MAGI) in 2022 was above $97,000 as a single person or $194,000 as a married couple filing jointly, your Part B and Part D premiums are higher in 2024. The more you earned, the more you pay — there are five income brackets, and the highest earners pay roughly three times the standard premium.
Medicare uses tax return information from two years prior, so 2024 premiums are based on 2022 income. If your income dropped in 2023 or 2024 — for example, because you retired or had a major life change — you can ask Medicare to recalculate using current income. You will need to file a form called the Life Changing Event notice and provide proof of the change.
These adjustments explore to both the standard Part B premium and to Part D plans. A person in the highest income bracket might pay $560+ per month for Part B alone instead of $164.90.
Part D prescription drug coverage premiums
Part D is optional, but if you do not sign up when you first become may be able to access and later want it, you pay a permanent penalty. The penalty is roughly 1% of the national average Part D premium for each month you were without coverage — currently about $1.50 per month per year of delay.
Part D premiums vary dramatically by plan and by pharmacy. A plan that covers your specific drugs might cost $8 per month, while another might cost $80. You choose a plan during the annual enrollment period (October 15 to December 7), and the plan you pick determines your premium. Some plans have $0 premiums but higher copays; others have higher premiums but lower copays.
You also pay a yearly deductible (up to $545 in 2024) before Part D starts to pay, and then you pay a percentage of drug costs until you hit the out-of-pocket limit (around $5,735 in 2024). After that, you pay a small copay for the rest of the year.
Medicare Advantage plan premiums and costs
Medicare Advantage (Part C) is an alternative to Original Medicare (Parts A and B). Many Advantage plans have $0 monthly premiums, which sounds appealing, but you still must pay your Part B premium ($164.90 in 2024). You also typically pay copays for doctor visits and hospital stays, and you must use doctors and hospitals in the plan's network.
Some Advantage plans include Part D prescription coverage; others do not. If your plan does not include it, you pay a separate Part D premium. Plans vary widely in cost and coverage, so comparing plans in your area is important — a $0-premium plan in one county might not be available in another, or might cover different drugs.
Advantage plans can change their premiums and coverage each year, so you should review your plan during open enrollment even if you have been happy with it. A plan that cost nothing one year might charge $50 the next.
Help paying premiums if your income is low
If your income is below 150% of the federal poverty level (roughly $1,900 per month for a single person in 2024, though this varies by state), you may may have access to for Medicaid to help pay your Part B premium. Some states also have programs that pay Part A and Part B premiums for people with slightly higher incomes.
For Part D, the Extra Help program (also called the Low-Income Subsidy) covers most or all of your premium and reduces your copays if your income is below 150% to 175% of poverty, depending on your state. You explore through Social Security, and the process takes a few weeks. Many people who may have access to do not know about it.
Contact your state Medicaid office or call 1-800-MEDICARE to ask whether you may have access to for either program. Bring recent pay stubs or tax returns to show your income.
When premiums change and how to stay informed
Medicare premiums change every January. The Part B premium and Part D average premium are announced in the fall, usually in October. If you have an Advantage plan, your plan sends you a notice in the fall telling you about any premium changes for the next year.
You receive a notice called the Annual Notice of Change (ANOC) from your Advantage plan by September 30 each year. Original Medicare beneficiaries do not get a plan notice, but Medicare.gov publishes the new Part B and Part D information, and you can call 1-800-MEDICARE to ask about your specific situation.
If your plan's premium or coverage changes in a way you do not like, you have until December 7 to switch to a different plan or to Original Medicare. This is your one may provide chance to change plans each year.
Frequently Asked Questions
Do I have to pay Part B if I do not want it?
Part B is optional, but if you delay signing up and do not have other health insurance, you pay a permanent 10% penalty on top of the premium for each year you were late. Most people sign up when they turn 65, even if they are still working, to avoid the penalty.
What if I cannot afford my Medicare premiums?
Contact your state Medicaid office or call 1-800-MEDICARE to ask about premium information programs. If your income is low, Medicaid or the Extra Help program may cover part or all of your premiums. Some nonprofits also offer emergency information, though availability varies by location.
Can I change my Part D plan if the premium goes up?
Yes, during the annual enrollment period from October 15 to December 7, you can switch to a different Part D plan or to an Advantage plan that includes Part D. You can also drop Part D entirely, though you will owe a penalty if you rejoin later.
Why did my Part B premium increase so much?
If your income was higher two years ago, Medicare charges you more based on that income. You can ask Medicare to recalculate if your income dropped due to retirement, job loss, or a major life event. File a Life Changing Event notice with proof of the change.
Are there any months when I do not have to pay a premium?
No. Part B and Part D premiums are charged every month you are enrolled, including months when you do not see a doctor or fill prescriptions. Part A has no monthly premium for most people, but you pay a deductible when you use hospital services.