Medicare costs break into four separate payments: Part A (hospital), Part B (doctor visits), Part D (prescription drugs), and optional Medigap or Medicare Advantage plans

Most people do not pay a monthly premium for Part A if they or their spouse paid Medicare taxes for at least 10 years while working. Part B costs roughly $165 to $560 per month in 2024, depending on your income — higher earners pay more. Part D (prescription drug coverage) varies by plan, typically $7 to $100+ per month. If you choose a Medigap supplemental plan or Medicare Advantage plan, those add another $0 to $300+ monthly. You also pay deductibles, copays, and coinsurance when you use care.

The exact amount you pay depends on three things: which parts you enroll in, your income level, and which insurance company's plan you choose. There is no single "Medicare cost" — it is a collection of separate bills. This guide walks through each one so you know what to expect.

Key Takeaways

  • Part A (hospital insurance) is free for most people who worked and paid Medicare taxes for 10 years, but costs $278 to $556 per month if you do not meet that requirement.
  • Part B (medical insurance) costs $165 to $560 per month depending on your income, and the amount increases each year.
  • Part D (prescription drugs) costs vary widely by plan and pharmacy, from under $10 to over $100 monthly, and you choose a new plan each year during open enrollment.
  • Medigap supplemental plans cost $100 to $300+ per month but cover costs that Original Medicare leaves behind, while Medicare Advantage plans often cost $0 to $50 monthly but limit which doctors you can see.
  • You also pay deductibles when you start care and copays or coinsurance each time you use a service, which add to your total yearly cost.

Part A: Hospital Insurance Costs

Most people pay nothing for Part A because they or their spouse worked long enough and paid Medicare taxes. You need at least 40 quarters (10 years) of work history to may have access to for premium-free Part A. If you do not meet that requirement, you can still enroll and pay a monthly premium.

If you do pay a Part A premium, the amount is $278 per month (if you have 30 to 39 quarters of work history) or $556 per month (if you have fewer than 30 quarters). These amounts change each year. Even with premium-free Part A, you pay a deductible when you are admitted to the hospital: $1,632 per benefit period in 2024. After that deductible, Part A covers most hospital costs for the first 60 days of a hospital stay. Days 61 through 90 cost you $408 per day. Beyond 90 days, costs rise further.

Part B: Doctor and Outpatient Care Costs

Part B covers doctor visits, lab tests, imaging, and outpatient procedures. The standard monthly premium is $165.90 in 2024, but you pay more if your income is higher. The income brackets change each year, and the higher your income, the more you pay — ranging from $165.90 to $560.50 per month for single filers in 2024.

You also pay a Part B deductible of $240 per year (2024), which you must meet before Part B starts to pay. After you meet the deductible, you typically pay 20 percent of the cost for most services, and the doctor or provider bills Medicare for the remaining 80 percent. There is no yearly cap on what you pay out of pocket for Part B services under Original Medicare, which is why many people add a Medigap plan.

Part D: Prescription Drug Coverage Costs

Part D is optional, but if you do not enroll when you first become may be able to access, you pay a penalty for as long as you have Medicare. The monthly premium varies by plan and insurance company — some plans cost $7 to $15 per month, while others cost $80 to $100+ per month. You choose a new plan each year during the annual enrollment period (October 15 to December 7).

You also pay a yearly deductible (usually $100 to $500, depending on the plan) before your plan starts to pay for drugs. After that, you pay a copay or coinsurance for each prescription. The amount depends on which "tier" your drug is on — generic drugs cost less, brand-name drugs cost more. Once you and your plan together spend $7,050 on drugs in a year (2024), you enter the "donut hole," where you pay a higher percentage of drug costs until you reach $10,500 out of pocket. After that, your plan covers most costs for the rest of the year.

Medigap Supplemental Plans: Coverage and Premiums

Medigap plans are sold by private insurance companies and cover costs that Original Medicare (Part A and Part B) leaves behind — like deductibles, copays, and coinsurance. There are 10 standardized Medigap plans (labeled A through N), and each covers a different combination of costs. Plan G and Plan N are the most common choices for new enrollees.

Medigap premiums range from roughly $100 to $300+ per month, depending on which plan you choose, your age, your location, and the insurance company. Premiums increase as you age and vary significantly by state and company — a Plan G might cost $150 per month in one state and $250 in another. You can enroll in Medigap during a six-month open enrollment window that starts the month you turn 65 and enroll in Part B. If you miss this window, you may face higher premiums or denial of coverage.

Medicare Advantage Plans: An Alternative to Original Medicare

Medicare Advantage (Part C) is an alternative to Original Medicare. Private insurance companies run these plans, and they must cover everything Part A and Part B cover, but they often do it through a network of doctors and hospitals. Many Medicare Advantage plans charge $0 to $50 per month in premiums, and some charge nothing at all.

However, Medicare Advantage plans typically have copays and coinsurance that can add up quickly, and they often require you to use doctors and hospitals within their network. They also usually include Part D drug coverage built in. If you travel frequently or want to see any doctor who accepts Medicare, Original Medicare with a Medigap plan may cost more upfront but give you more flexibility. Medicare Advantage plans change their benefits and networks each year, so you must review your options during open enrollment (October 15 to December 7).

Income-Related Premiums and How They Work

If your income is above a certain threshold, you pay a higher monthly premium for Part B and Part D. These are called Income-Related Monthly Adjustment Amounts (IRMAA). The income thresholds are based on your modified adjusted gross income from two years prior — so your 2024 premiums are based on your 2022 income.

For 2024, single filers with income above $97,000 pay more for Part B. The more you earn, the higher the surcharge. Part D premiums also increase based on income. If your income drops due to retirement, job loss, or other life changes, you can request that Medicare recalculate your premiums using your current year income instead of the two-year-old figure. You must file a form and provide proof of the change within 60 days of the event.

Deductibles, Copays, and Coinsurance You Pay Out of Pocket

Beyond premiums, you pay costs each time you use care. Deductibles are amounts you must pay before your insurance starts to help — Part A has a $1,632 deductible per hospital stay, and Part B has a $240 yearly deductible. Copays are fixed amounts you pay for a specific service, like $25 for a doctor visit. Coinsurance is a percentage of the cost you pay after the deductible is met — for example, 20 percent of the cost of an outpatient surgery.

Under Original Medicare, there is no yearly limit on what you pay out of pocket for Part B services. This means if you have a serious illness or injury requiring many doctor visits and procedures, your costs can grow very large. This is why many people add a Medigap plan, which covers these out-of-pocket costs. Medicare Advantage plans do have an out-of-pocket maximum (usually $7,000 to $10,000 per year), which limits your total costs.

Frequently Asked Questions

Do I have to pay for Part A if I worked long enough?

No. If you or your spouse worked and paid Medicare taxes for at least 10 years, you do not pay a monthly premium for Part A. You still pay the hospital deductible when you are admitted, but there is no monthly bill.

Why does my Part B premium change every year?

Part B premiums increase each year to account for inflation and rising healthcare costs. The exact increase is set by Congress and announced in the fall. Your premium may also increase if your income rises above the IRMAA thresholds.

Can I skip Part D if I do not take many medications?

You can skip Part D when you first turn 65, but if you do not enroll and later decide you need it, you pay a penalty for every month you were without coverage. The penalty is roughly 1 percent of the national average Part D premium per month and lasts as long as you have Medicare.

Is Medigap or Medicare Advantage cheaper?

It depends on your health and how much care you use. Medicare Advantage often has lower or no premiums but higher copays and coinsurance per visit. Medigap has higher premiums but lower out-of-pocket costs per service. If you see many doctors or specialists, Medigap may cost less overall.

What happens if I cannot afford my Medicare premiums?

You may may have access to for programs that help pay premiums and out-of-pocket costs, such as Medicaid (if your income is low enough) or the Medicare Savings Program. Contact your state Medicaid office or call 1-800-MEDICARE to learn what you may may have access to for based on your income and assets.