Medicare costs in 2025 depend on which parts you choose and your income

Medicare has four parts, and each one costs differently. Part A (hospital insurance) is free for most people at 65. Part B (doctor visits and outpatient care) costs $174.70 per month for most people in 2025, though higher earners pay more. Part D (prescription drugs) varies by plan, usually $7 to $100+ per month. Part C (Medicare Advantage) replaces Parts A and B with a private plan, typically costing $0 to $300+ per month depending on the plan and your location.

Your actual costs also include deductibles, copayments, and coinsurance — the amounts you pay when you use care. Part A has a $1,676 deductible per hospital stay in 2025. Part B has a $240 annual deductible, then you pay 20% of approved costs. These numbers change every year.

If your income is higher than a certain threshold, you pay an extra amount called Income-Related Monthly Adjustment Amount (IRMAA). For 2025, this kicks in if your modified adjusted gross income from two years ago was above $103,000 for a single person or $206,000 for a married couple filing jointly. The higher your income, the more you pay on top of the standard premium.

Key Takeaways

  • Part A is free for most people; Part B costs $174.70 per month in 2025 for standard earners, with higher earners paying more through IRMAA.
  • Part A has a $1,676 hospital deductible per stay; Part B has a $240 annual deductible plus 20% coinsurance after that.
  • Part D prescription drug costs vary by plan and pharmacy, typically $7 to $100+ monthly, and plans change every year.
  • Medicare Advantage plans often have $0 monthly premiums but may have higher copayments and restricted provider networks.
  • Your income from two years prior determines whether you pay extra IRMAA charges on top of standard premiums.

Part A costs and what they cover

Part A covers hospital stays, skilled nursing facility care, hospice, and some home health services. Most people pay nothing for Part A because they or their spouse paid Medicare taxes for at least 10 years while working. If you did not work long enough, you can buy Part A for $278 to $505 per month in 2025, depending on how many years you worked.

When you use Part A, you pay the deductible once per benefit period — not once per year. A benefit period starts when you enter the hospital and ends 60 days after you leave without needing hospital or skilled nursing care. If you go back to the hospital after that 60-day gap, a new benefit period begins and you pay the deductible again. In 2025, that deductible is $1,676 per benefit period.

After you pay the deductible, Part A covers all approved hospital costs for days 1 through 60. Days 61 through 90 cost you $419 per day in 2025. If you need more than 90 days, you have 60 "lifetime reserve days" you can use, each costing $838 per day. After that, you pay all costs.

Part B costs and what they cover

Part B covers doctor visits, outpatient surgery, diagnostic tests, physical therapy, and durable medical equipment like wheelchairs. The standard monthly premium is $174.70 in 2025 for people whose income is below the IRMAA threshold. This premium is deducted from your Social Security check automatically unless you asked Medicare to bill you instead.

You also pay an annual deductible of $240 in 2025. After you meet that deductible, you pay 20% of the Medicare-approved amount for most services. Medicare-approved amount is not the same as what a doctor charges — it is the amount Medicare decides is reasonable for that service. If a doctor does not accept Medicare, you may pay more.

Some preventive services — like annual wellness visits, cancer screenings, and vaccines — have no copayment or coinsurance after you meet the deductible. Your doctor's office can tell you which services are covered at no cost.

Part D prescription drug coverage and costs

Part D is optional but important: if you do not sign up when you first become may be able to access at 65, you pay a penalty for every month you go without it, even if you do not take any drugs. The penalty is roughly 1% of the national average Part D premium per month you were not covered. That penalty stays on your premium for as long as you have Medicare.

Part D plans are run by private insurance companies, and each plan has a different list of covered drugs, different copayments, and different monthly premiums. In 2025, premiums range from about $7 to over $100 per month depending on the plan. The same drug can cost $5 in one plan and $50 in another, so comparing plans matters.

Most Part D plans have a coverage gap called the "donut hole." Once you and your plan have spent $5,850 on covered drugs in 2025, you enter the gap and pay more out of pocket until total spending reaches $7,050. Then catastrophic coverage kicks in and you pay a small copayment. Plans vary in how much you pay in the gap, so read the plan details before you choose.

Medicare Advantage (Part C) costs and trade-offs

Medicare Advantage is an alternative to Original Medicare (Parts A and B). Private insurance companies run these plans, and many have $0 monthly premiums. However, you typically pay higher copayments when you see a doctor — often $30 to $50 per visit instead of 20% coinsurance. You also must use doctors and hospitals in the plan's network, except in emergencies.

Most Medicare Advantage plans include Part D prescription drug coverage built in, so you do not buy it separately. Some plans also cover dental, vision, or hearing aids — benefits Original Medicare does not cover. These extra benefits have value, but they come with trade-offs: less choice of providers, higher copayments, and sometimes prior authorization requirements before you can see a specialist.

Medicare Advantage plans change every year. A plan you had in 2024 might change its premium, copayments, or covered drugs in 2025. You can switch plans during the Annual Enrollment Period from October 15 to December 7 each year, or you can switch back to Original Medicare during that same window.

Income-Related Monthly Adjustment Amount (IRMAA)

If your income is above a certain level, Medicare charges you extra on top of your Part B and Part D premiums. This extra charge is IRMAA. For 2025, IRMAA applies if your modified adjusted gross income from 2023 was above $103,000 for a single person or $206,000 for a married couple filing jointly.

The more your income exceeds the threshold, the more you pay. A single person with income of $103,001 to $129,000 pays an extra $70 per month on Part B in 2025. Someone with income above $194,000 pays an extra $280 per month. Part D has its own IRMAA scale, starting at an extra $12 per month.

If your income drops — because you retire, lose a job, or have a major life change — you can ask Medicare to recalculate your IRMAA using your current year's income instead of the two-year-old figure. You must report the change within 60 days and provide proof, such as a recent tax return or a letter from your employer.

What is not covered by Medicare

Medicare does not cover dental care, vision exams, eyeglasses, or hearing aids, though some Medicare Advantage plans offer limited coverage. It does not cover long-term care in a nursing home or assisted living facility — only skilled nursing care for a limited time after a hospital stay. It does not cover routine foot care, cosmetic surgery, or most weight-loss drugs.

Many people buy Medigap (supplemental insurance) to cover costs Medicare does not pay, such as the Part B coinsurance. Medigap premiums vary widely by plan and location, typically $100 to $300+ per month. Others choose Medicare Advantage instead, which includes some extra benefits but limits your choice of doctors.

Frequently Asked Questions

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

No. If you or your spouse paid Medicare taxes for at least 10 years while working, Part A is free. If you did not work that long, you can buy it for $278 to $505 per month in 2025, depending on how many years you did work.

What happens if I do not sign up for Part D when I turn 65?

You pay a penalty of roughly 1% of the national average Part D premium for every month you go without coverage. That penalty is added to your premium permanently, even if you sign up later. The penalty applies only if you do not have other drug coverage that is at least as good as Part D.

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

Yes. During the Annual Enrollment Period from October 15 to December 7 each year, you can switch Part D plans, switch to or from Medicare Advantage, or switch back to Original Medicare. You can also make changes if you have a may have access to life event, such as moving out of your plan's service area.

How do I know if I will pay IRMAA?

Medicare uses your modified adjusted gross income from two years ago. For 2025 premiums, Medicare looks at your 2023 tax return. If your income was above $103,000 (single) or $206,000 (married filing jointly), you pay extra. You can check your income estimate on your Medicare.gov account or call Social Security at 1-800-772-1213.

What should I ask my doctor about Medicare costs?

Ask whether your doctor accepts Medicare assignment, what your copayment or coinsurance will be, and whether you need prior authorization for any tests or referrals. Ask which preventive services are covered at no cost. If a test or procedure is recommended, ask whether it is covered under your plan before you have it done.