Medicare premiums and deductibles for 2025

Medicare costs change every year. For 2025, Part B premiums (doctor visits and outpatient care) are $177.90 per month for most people. Part A (hospital care) is free for most seniors who paid Medicare taxes while working. Part D (prescription drugs) premiums vary by plan, typically ranging from $7 to $100+ per month depending on which plan you choose.

These are the baseline costs. Your actual out-of-pocket expenses depend on which parts of Medicare you use, whether you have a Medigap or Medicare Advantage plan, and how much medical care you need during the year. Someone who rarely sees a doctor pays far less than someone managing multiple chronic conditions.

Key Takeaways

  • Part B premiums for 2025 are $177.90 per month for most people, though higher earners pay more through Income-Related Monthly Adjustment Amounts (IRMAA).
  • Part A is free for most seniors, but you pay a $1,676 deductible per hospital stay in 2025.
  • Part D prescription drug premiums vary widely by plan and change yearly, so comparing plans during open enrollment is essential.
  • Medicare Advantage plans have different cost structures than Original Medicare plus Medigap, with some charging $0 premiums but higher copays at the doctor.
  • Your income from two years ago determines whether you pay extra for Part B and Part D through IRMAA surcharges.

Part A hospital costs in 2025

Part A covers inpatient hospital stays, skilled nursing facility care, hospice, and some home health services. You do not pay a monthly premium if you or your spouse paid Medicare taxes for at least 10 years. However, you do pay when you use the benefit.

For 2025, the Part A deductible is $1,676 per hospital stay. This means you pay the first $1,676 of hospital charges yourself. After you meet the deductible, Medicare covers all costs for days 1 through 60 of a hospital stay. Days 61 through 90 cost you $419 per day. Beyond 90 days, you enter your "lifetime reserve days" — a one-time pool of 60 extra days that cost $838 per day.

A skilled nursing facility stay (after a hospital stay) costs you $209.50 per day for days 21 through 100. Days 1 through 20 are covered fully after you meet the Part A deductible.

Part B doctor and outpatient costs in 2025

Part B covers doctor visits, lab tests, imaging, outpatient surgery, and durable medical equipment. The monthly premium is $177.90 for 2025 if your income is below certain thresholds. If your modified adjusted gross income from 2023 was higher, you pay an extra surcharge called an Income-Related Monthly Adjustment Amount (IRMAA).

Beyond the premium, you also pay a $240 annual deductible in 2025 before Medicare starts paying its share. After you meet the deductible, Medicare typically covers 80% of approved charges, and you pay 20%. For some services like preventive care (annual wellness visits, cancer screenings, vaccines), you pay nothing after the deductible.

If you see doctors who do not accept Medicare assignment, you may pay more. Doctors who accept assignment agree to charge only what Medicare allows. Those who do not can charge up to 15% more than the Medicare-approved amount, and you are responsible for the difference.

Part D prescription drug costs in 2025

Part D premiums vary significantly by plan and region. Plans are offered by private insurance companies approved by Medicare, and each plan has its own formulary (list of covered drugs) and cost structure. Some plans charge $7 per month; others charge $100 or more. The average is typically in the $30 to $50 range, but this changes year to year.

When you fill a prescription, you usually pay a copay or coinsurance. Early in the year, you pay your plan's copay amounts. Once you and your plan have spent $6,500 combined on covered drugs in 2025, you enter the "coverage gap" — a phase where you pay 25% of drug costs until your out-of-pocket spending reaches $8,550. After that, you pay a small copay for the rest of the year.

If you do not enroll in Part D when you first become may be able to access, you may pay a permanent penalty if you join later. The penalty is roughly 1% of the national average Part D premium for each month you were not covered.

Income-Related Monthly Adjustment Amounts (IRMAA) in 2025

If your income is above certain levels, you pay extra for Part B and Part D. Medicare uses your modified adjusted gross income from your tax return from two years prior — so in 2025, they use your 2023 income. The thresholds are different for single filers and married couples filing jointly.

For 2025, if you are single and your 2023 income was over $97,000, you pay an IRMAA surcharge on top of your Part B premium. The surcharge ranges from $71.30 to $356.40 per month depending on your income level. Part D has similar surcharges. Married couples filing jointly have higher thresholds but face the same surcharge structure if they exceed them.

If your income drops significantly — due to retirement, loss of a spouse, or other life events — you can request that Medicare recalculate your IRMAA using your current year income instead of the prior year figure. You must file a form called the Medicare Income-Related Monthly Adjustment Amount — Life-Changing Event with Social Security.

Medicare Advantage versus Original Medicare costs

Medicare Advantage (Part C) is an alternative to Original Medicare. Many Medicare Advantage plans charge $0 monthly premiums, which attracts seniors on tight budgets. However, the trade-off is usually higher copays and coinsurance when you use care. A doctor visit might cost $30 to $50 per visit instead of 20% coinsurance.

Medicare Advantage plans also include prescription drug coverage built in, so you do not enroll in a separate Part D plan. Out-of-pocket maximums are capped — in 2025, the maximum is typically $7,550 for in-network care — meaning once you hit that limit, the plan covers everything for the rest of the year.

Original Medicare plus a Medigap supplemental policy works differently. You pay Part B premiums, meet deductibles, and pay coinsurance, but a Medigap plan covers much of what Original Medicare does not. Medigap premiums vary widely by plan type and insurer, typically ranging from $100 to $300+ per month. The advantage is predictability: you know your copays upfront and can see any doctor who accepts Medicare.

Costs you should plan for beyond premiums

Medicare does not cover everything. Dental care, vision exams, hearing aids, and long-term care are not covered by any part of Medicare. Some Medicare Advantage plans offer limited dental or vision benefits, but Original Medicare does not. If you need these services, you either pay out of pocket or purchase separate insurance.

You are also responsible for any charges from providers who do not accept Medicare. If you travel outside the United States, Medicare generally does not cover care, though some Medigap plans offer limited foreign travel coverage. Experimental treatments and certain elective procedures are also not covered.

Many seniors underestimate these gaps and face unexpected bills. Before you choose a plan, think about what services matter most to you — if you wear hearing aids or see a dentist regularly, a Medicare Advantage plan with those benefits might save you money even if the premium is higher.

Frequently Asked Questions

Do I have to pay for Part A if I worked and paid Medicare taxes?

No. If you or your spouse paid Medicare taxes for at least 10 years, Part A is free. You still pay the deductible and copays when you use hospital or skilled nursing services, but there is no monthly premium. If you did not work long enough, you may be able to buy Part A, but the premium can be $278 to $556 per month depending on your work history.

Why does my Part B premium change from year to year?

Part B premiums are set annually based on the cost of providing the benefit and projected enrollment. They also increase if your income rises above IRMAA thresholds. Social Security announces the new premium amount in October each year, and it takes effect January 1. You can see the current premium on your Social Security statement or Medicare.gov.

What happens if I miss the Part D enrollment important date?

If you do not enroll in Part D when you first become may be able to access, you pay a permanent late enrollment penalty of roughly 1% of the national average Part D premium for each month you were not covered. This penalty stays with you for life, even if you join a plan later. You can enroll during the annual open enrollment period (October 15 to December 7) or if you have a may have access to life event.

Can I change my Medicare plan if costs are too high?

Yes, but timing matters. During the annual open enrollment period (October 15 to December 7), you can switch between Medicare Advantage and Original Medicare, or change to a different plan. If you have a may have access to life event — such as loss of employer coverage, moving to a new state, or a significant drop in income — you may be able to change plans outside the open enrollment window.

How do I know if my IRMAA surcharge is correct?

Social Security sends you a notice called the Medicare Income-Related Monthly Adjustment Amount Notice if you owe a surcharge. Review it carefully against your tax return. If your income has dropped since the year they used, or if there is an error on the notice, you can request a recalculation by filing a form with Social Security. You have 60 days from the date on the notice to appeal.