Medicare costs vary by the type of coverage you choose and your income level

Medicare has different costs depending on whether you pick Original Medicare (Parts A and B) or a Medicare Advantage plan (Part C). Part A, which covers hospital stays, is free for most people who paid Medicare taxes while working. Part B, which covers doctor visits and outpatient care, costs a monthly premium that changes each year. In 2025, the standard Part B premium is $185 per month, though you may pay more if your income is higher. Medicare Advantage plans have their own premiums, which vary by plan and location but are often lower than Part B alone.

Beyond premiums, you also pay out-of-pocket costs when you use care. Original Medicare requires you to pay a deductible before coverage begins, and then you share the cost of services with Medicare through copayments and coinsurance. Medicare Advantage plans typically have lower out-of-pocket limits but may require you to use doctors within their network. Prescription drug coverage (Part D) adds another monthly cost, ranging widely depending on which plan you choose.

Key Takeaways

  • Part B premiums are $185 per month in 2025 for most people, but higher earners pay more through Income-Related Monthly Adjustment Amounts (IRMAA).
  • Part A (hospital insurance) is free for most people, but you pay a deductible of $1,676 per hospital stay in 2025.
  • Original Medicare has no monthly premium for Part A, but Medicare Advantage plans have varying premiums that depend on your location and the specific plan.
  • Prescription drug coverage (Part D) premiums vary by plan, and you pay more if you have higher income.
  • Your actual costs depend on which type of Medicare you choose, how much medical care you use, and whether your income triggers higher premiums.

Part A and Part B premiums and deductibles in 2025

Part A is hospital insurance, and most people pay nothing for the premium because they or their spouse paid Medicare taxes for at least 10 years while working. However, you do pay a deductible when you use hospital services. In 2025, the Part A deductible is $1,676 per hospital stay. If you stay in the hospital for more than 60 days, you also pay coinsurance of $419 per day for days 61 through 90, and $838 per day for days 91 and beyond (up to 60 lifetime reserve days).

Part B is medical insurance for doctor visits, lab tests, and outpatient services. The standard monthly premium for Part B in 2025 is $185. You also pay a Part B deductible of $240 per year before Medicare starts to pay its share. After you meet the deductible, you typically pay 20% of the cost of covered services, and Medicare pays 80%. These amounts explore to people whose modified adjusted gross income falls below certain thresholds; higher earners pay more.

Income-related premium increases (IRMAA) explained

If your income is above a certain level, you pay a higher monthly premium for Part B and Part D. This is called an Income-Related Monthly Adjustment Amount (IRMAA). Medicare uses your tax return from two years ago to calculate your income, so 2025 premiums are based on your 2023 income. For 2025, if you are single and your modified adjusted gross income is more than $103,000, you begin to pay extra. If you are married filing jointly, the threshold is $206,000.

The higher you earn, the more you pay. For example, a single person with income between $103,000 and $129,000 pays an additional $74 per month on top of the standard $185 Part B premium. Someone with income above $499,000 pays an additional $296 per month. These amounts change each year. If your income drops significantly — for example, because you retired or had a major life event — you can ask Medicare to recalculate your premium based on your current income rather than your two-year-old tax return.

Medicare Advantage plan costs

Medicare Advantage (Part C) plans are offered by private insurance companies approved by Medicare. Many plans have a $0 monthly premium, meaning you pay only the Part B premium to Medicare and nothing extra to the plan itself. However, some plans do charge a monthly premium on top of Part B. When you use care, you typically pay a copay for doctor visits (often $10 to $50) and coinsurance for hospital stays. Most Medicare Advantage plans have an out-of-pocket maximum, which means once you reach a certain spending limit in a year, the plan covers the rest of your care.

The trade-off is that Medicare Advantage plans usually require you to use doctors and hospitals within their network. If you go out of network, you may pay more or the plan may not cover the service at all. Plans also vary by location, so the options available to you depend on where you live. You can compare plans during the annual enrollment period (October 15 to December 7) using the Medicare Plan Finder tool on Medicare.gov.

Prescription drug coverage (Part D) costs

Part D covers prescription medications, and you can add it to Original Medicare or get it through a Medicare Advantage plan that includes drug coverage. Part D premiums vary widely depending on which plan you choose and your income level. In 2025, premiums range from roughly $7 to $100 per month, though this varies by plan and location. If your income is high enough to trigger IRMAA, you also pay an additional amount for Part D on top of the plan premium.

When you fill a prescription, you pay out-of-pocket costs that depend on the plan and the drug. Most plans have a deductible (up to $545 in 2025), after which you pay a copay or coinsurance for each prescription. There is also a coverage gap, sometimes called the "donut hole," where you pay a larger share of drug costs once you and your plan have spent a certain amount. Once your total out-of-pocket spending reaches $8,850 in 2025, catastrophic coverage kicks in and you pay only a small copay for the rest of the year.

Medigap (supplemental insurance) premiums

If you have Original Medicare, you can buy a Medigap policy from a private insurance company to help pay the costs that Medicare does not cover, such as deductibles, copayments, and coinsurance. Medigap premiums vary by the plan you choose, your age, your location, and the insurance company. There is no single cost; you need to get quotes from multiple insurers. Some Medigap plans are more comprehensive and cost more, while others cover fewer gaps and cost less.

You have the best chance of getting Medigap coverage at a reasonable rate if you enroll within six months of turning 65 and signing up for Part B. After that window, insurers can charge you more based on your health history. Medigap is not available to people with Medicare Advantage plans; if you have a Medicare Advantage plan, you cannot also have Medigap.

How to estimate your total Medicare costs

Your total annual Medicare cost depends on several factors: which parts of Medicare you choose, how much medical care you use, your income level, and whether you buy supplemental coverage. To get a rough estimate, add up your monthly premiums (Part B at minimum, plus Part D if you want drug coverage, plus any plan premium if you have Medicare Advantage or Medigap), multiply by 12, and then add the deductibles and out-of-pocket costs you expect to pay based on your health needs.

The Medicare Plan Finder tool on Medicare.gov lets you enter your prescriptions and preferred doctors to see estimated costs for different plans in your area. You can also call 1-800-MEDICARE to speak with someone who can walk you through the options. If your income is low, you may be able to get help paying premiums and out-of-pocket costs through programs like the Low-Income Subsidy (LIS) or the Medicare Savings Programs (MSP), which are run by your state.

Frequently Asked Questions

Do I have to pay for Part A?

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. However, you do pay a deductible ($1,676 in 2025) when you use hospital services. If you do not have enough work history, you may be able to buy Part A coverage for a monthly premium.

Why did my Part B premium go up?

Part B premiums change each year based on the cost of medical care and other factors. Your premium may also increase if your income rose above the IRMAA thresholds. If you believe your income has dropped significantly since your last tax return, you can contact Social Security to ask for a recalculation based on your current income.

Can I switch Medicare plans if I do not like the costs?

Yes, during the annual enrollment period from October 15 to December 7, you can switch from Original Medicare to Medicare Advantage, from Medicare Advantage to Original Medicare, or change to a different plan. Changes take effect January 1. If you have a major life event like losing employer coverage, you may be able to switch at other times of the year.

What happens if I cannot afford my Medicare premiums?

If your income is low, you may be able to get help through the Medicare Savings Programs (MSP) or the Low-Income Subsidy (LIS). These programs are run by your state and can help pay your Part B premium, deductibles, and coinsurance. Contact your state Medicaid office or call 1-800-MEDICARE to learn about you may have access to.

Are there any costs I do not have to pay?

Yes. Part A is free for most people. Preventive services like annual wellness visits, cancer screenings, and vaccinations are covered by Medicare with no copay or coinsurance. However, you still pay the Part B deductible before these services are covered, and you must see a participating provider.