Medicare has four cost layers: premiums you pay monthly, deductibles you pay before coverage starts, copays per visit, and coinsurance for ongoing care

The amount you pay depends on which part of Medicare you choose, your income, and whether you add prescription drug coverage. Original Medicare (Parts A and B) costs less upfront for most people but leaves you exposed to larger bills later. Medicare Advantage (Part C) bundles everything into one monthly premium but often limits which doctors you can see. Part D (prescription drugs) is separate and varies wildly by plan and pharmacy.

The federal government sets the base premium amounts each year. In 2025, the standard Part B premium is $185 per month, but yours may be higher if your income exceeds certain thresholds. Part A (hospital insurance) is free for most people who paid Medicare taxes while working. These numbers change annually, so what you paid last year will not match what you pay this year.

Key Takeaways

  • Part A (hospital) is free for most people; Part B (doctor visits) costs $185 monthly in 2025, but higher-income retirees pay more through income-related adjustments.
  • Original Medicare has no monthly premium for Part A, lower Part B premiums than Advantage plans, but you pay 20% coinsurance on most services after the deductible.
  • Medicare Advantage plans bundle Parts A, B, and usually D into one premium, often $0 to $50 monthly, but cap your out-of-pocket costs and limit your choice of doctors.
  • Part D (prescription drugs) costs $7 to $20 monthly for the plan itself, plus copays at the pharmacy that vary by drug tier and your plan choice.
  • You pay income-related premiums if your modified adjusted gross income exceeds $97,000 (single) or $194,000 (married filing jointly), adding $70 to $560 monthly to Part B and Part D.

Original Medicare Part A and Part B costs

Part A covers hospital stays, skilled nursing, hospice, and some home health. You pay nothing monthly if you or your spouse paid Medicare taxes for at least 10 years. If you do not meet that requirement, the premium ranges from $278 to $556 per month in 2025, depending on how many quarters of work history you have.

Part B covers doctor visits, outpatient care, lab work, and medical equipment. The standard premium is $185 per month in 2025. You also pay a $240 deductible per year before Part B coverage begins. After that, you pay 20% of the approved amount for most services — meaning if a doctor visit is approved at $200, you pay $40 and Medicare pays $160.

Hospital stays under Part A cost you $1,632 for the first 60 days in 2025 (the deductible), then nothing for days 61–90, then $408 per day for days 91–150. Beyond 150 days, you pay the full cost. These numbers reset each benefit period, which begins the day you enter the hospital and ends 60 days after you leave.

Medicare Advantage (Part C) monthly costs and limits

Medicare Advantage plans are sold by private insurers and bundle Parts A, B, and usually D into one plan. Many plans charge $0 to $50 monthly, which sounds cheaper than Original Medicare. The catch is that you typically pay copays at every visit ($20–$50 for a doctor, $250–$500 for an emergency room) and coinsurance on hospital stays and major services.

The real protection in Advantage is the out-of-pocket maximum, which caps your total spending per year. In 2025, that maximum ranges from $4,500 to $8,500 depending on the plan. Once you hit that number, the plan pays 100% of covered services for the rest of the year. Original Medicare has no such cap, which is why some people spend thousands more in a single illness.

Advantage plans also restrict which doctors and hospitals you can use without paying extra. Most use a network model: you pay less if you see in-network providers and more (or nothing is covered) if you see out-of-network ones. If you travel or have a specialist you want to keep, check the plan's network before you sign up.

Prescription drug coverage (Part D) costs

Part D is optional but carries a penalty if you delay signing up. The monthly premium for a standalone Part D plan ranges from $7 to $20 in most areas, though some plans cost more. If you choose a Medicare Advantage plan, drug coverage is usually included in that plan's premium.

Once you enroll in Part D, you pay a deductible (usually $0 to $550 per year) before the plan covers anything. After that, you pay a copay or coinsurance for each prescription. Drugs are sorted into tiers: generic drugs cost $5–$15, preferred brand-name drugs cost $25–$50, and non-preferred drugs cost $50–$100 or more. Your plan's formulary (the list of covered drugs) determines which tier your medication falls into.

There is also a coverage gap called the "donut hole." Once you and your plan have spent $5,850 combined on drugs in 2025, you enter the gap and pay 25% of drug costs until your out-of-pocket spending reaches $8,550. Then catastrophic coverage kicks in and you pay only 5% of costs for the rest of the year. This gap affects people taking expensive medications; most people never reach it.

Income-related premiums for higher earners

If your modified adjusted gross income (MAGI) exceeds $97,000 as a single filer or $194,000 as a married couple filing jointly in 2025, you pay extra. These income thresholds are based on your tax return from two years prior, so your 2025 premiums depend on your 2023 income.

The extra amount ranges from $70 to $560 per month for Part B and from $8 to $77 per month for Part D, depending on how far your income exceeds the threshold. If you have a major life event — retirement, death of a spouse, large inheritance — you can request that Medicare recalculate your premiums using your current year income instead.

Supplemental insurance (Medigap) costs

Medigap policies are sold by private insurers and cover some of the costs that Original Medicare does not — like the 20% coinsurance, deductibles, and copays. They do not work with Medicare Advantage; you choose either Advantage or Original Medicare plus Medigap.

Medigap premiums range from $100 to $400 per month depending on the plan letter (A through N) and your age and location. Plan G and Plan N are the most common. Plan G covers almost everything except the Part B deductible; Plan N covers most things but leaves you paying small copays for doctor visits and emergency room trips. Buying Medigap is optional, but without it, a serious illness can cost you tens of thousands in coinsurance.

When and how premiums change each year

Medicare premiums are set by the Centers for Medicare & Medicaid Services (CMS) and announced in the fall for the following year. Part B and Part D premiums can change significantly year to year based on healthcare costs and program spending. Part A premiums change less often because they are tied to hospital insurance trust fund reserves.

Your premiums are usually deducted automatically from your Social Security check. If you are not yet receiving Social Security, you receive a bill from Medicare each month. If your income changes during the year — you retire, you get a large bonus, a spouse dies — you can contact Social Security to request a recalculation of your income-related premiums.

Frequently Asked Questions

Do I have to pay for Part A?

No, if you or your spouse paid Medicare taxes for at least 10 years while working. If you do not meet that requirement, Part A costs $278 to $556 per month in 2025. You can enroll in Part A even if you do not enroll in Part B.

What is the difference between what I pay now and what I will pay next year?

Premiums change every January. Part B and Part D premiums are announced each October for the following year. Part A premiums change less frequently. Your specific premium may also change if your income changes or if you turn 65 and become newly may be able to access.

Can I switch plans if the cost is too high?

Yes, during the Annual Enrollment Period from October 15 to December 7 each year, you can switch from Original Medicare to Advantage, from Advantage to Original, or change your Part D plan. If you have a major life event like retirement or loss of coverage, you may be able to switch outside this window.

Do I pay the same amount for Medicare Advantage as Original Medicare?

Not necessarily. Advantage plans often have lower or zero monthly premiums but charge copays at each visit. Original Medicare has a higher Part B premium but lower per-visit costs. The total you pay depends on how often you see doctors and which services you use.

What happens if I cannot afford my premiums?

If your income is low, you may be may be able to access for the Medicare Savings Program, which helps pay Part B and Part D premiums. Contact your state Medicaid office or call 1-800-MEDICARE to learn whether you may have access to based on your income and resources.