Medicare Part A and Part B premiums and deductibles
Medicare Part A (hospital insurance) costs most people nothing in premiums if they or their spouse paid Medicare taxes for at least 10 years while working. If you do not meet that requirement, the monthly premium ranges from about $278 to $556, depending on how many quarters of coverage you have. Part A also has a deductible: $1,676 per hospital stay in 2024.
Medicare Part B (medical insurance) has a monthly premium that changes each year. For 2024, the standard premium is $164.90 per month for most people, though higher earners pay more through an income-related adjustment. Part B also has a $240 annual deductible in 2024, after which Medicare covers 80 percent of approved services and you pay 20 percent.
These amounts are set by Medicare each year and announced in the fall for the following year. If you enroll late in Part B, you may pay a permanent penalty on top of the standard premium — 10 percent more for each year you delayed enrollment without a valid reason.
Key Takeaways
- Most people pay nothing for Part A premiums because they worked and paid Medicare taxes, but Part A has a $1,676 deductible per hospital stay.
- Part B premiums are $164.90 per month in 2024 for standard earners, plus a $240 annual deductible, and higher earners pay more based on their income.
- If you delay enrolling in Part B without a valid reason, you will pay a permanent 10 percent penalty on your monthly premium for life.
- Part A and Part B together do not cover everything — you still pay coinsurance and copays, and neither covers dental, vision, or hearing aids.
Who pays Part A premiums and who does not
You pay no Part A premium if you or your spouse worked and paid Medicare taxes for at least 40 quarters (10 years). This covers the vast majority of people who reach age 65. If you worked fewer than 40 quarters, you can still enroll, but you will pay a monthly premium.
If you worked 30 to 39 quarters, the 2024 premium is $278 per month. If you worked fewer than 30 quarters, the premium is $556 per month. These amounts change each year. You can find your exact quarter count by creating an account on ssa.gov and viewing your Social Security statement, which lists your covered earnings history.
If you are not yet 65 but have been on Social Security disability for at least 24 months, or if you have end-stage renal disease or ALS, you may be able to enroll in Medicare earlier and may may have access to for premium-free Part A even if you have not worked 40 quarters.
How Part B premiums work and income-related adjustments
The standard Part B premium for 2024 is $164.90 per month. However, if your modified adjusted gross income (MAGI) from two years prior exceeds certain thresholds, you pay more. For example, if you filed taxes individually and your 2022 MAGI was over $97,000, you paid a higher premium in 2024. If you were married filing jointly and your 2022 MAGI was over $194,000, the same rule applied.
These income thresholds are adjusted each year, and the extra amount you pay can range from about $65 to $560 per month on top of the standard premium, depending on your income level. Medicare uses your tax return from two years prior, so if your income dropped significantly, you can request a recalculation by submitting a Life-Changing Event form to Social Security.
You receive a notice each year in December showing your Part B premium for the following year. If the amount surprises you or seems wrong, you have 30 days to appeal or request a recalculation based on a recent change in income.
Deductibles, coinsurance, and what you pay after premiums
Paying your Part A and Part B premiums does not mean Medicare covers everything. Part A has a $1,676 deductible per hospital stay in 2024 — you pay this amount before Medicare begins to pay. After you meet the deductible, Medicare covers all approved inpatient hospital costs for the first 60 days of a stay. Days 61 through 90 require a $419 daily coinsurance payment from you. Beyond 90 days, costs rise further.
Part B works differently. After you pay the $240 annual deductible, Medicare covers 80 percent of approved services (such as doctor visits and outpatient procedures), and you pay the remaining 20 percent. This is called coinsurance. There is no annual cap on how much you pay out of pocket for Part B coinsurance, which is why many people buy a Medigap policy to cover these costs.
Part A and Part B also do not cover dental care, vision care, hearing aids, or most prescription drugs. You need separate coverage for these services — either through a Medicare Advantage plan (Part C), a standalone prescription drug plan (Part D), or a Medigap policy.
Late enrollment penalties for Part B
If you do not enroll in Part B when you first become may be able to access at age 65, and you do not have a valid reason for the delay, you will pay a permanent penalty. The penalty is 10 percent of the standard Part B premium for each full year you were may be able to access but did not enroll. If you delayed for three years, you pay 30 percent more than the standard premium for the rest of your life.
Valid reasons for delaying enrollment without penalty include having employer health coverage through a current job, or being covered under a spouse's employer plan. Once that coverage ends, you have a special enrollment period (usually eight months) to sign up for Part B without penalty. If you miss this window, the penalty applies.
Part A does not have a late enrollment penalty, but delaying Part A enrollment can still cost you money if you do not have premium-free coverage. The sooner you enroll, the sooner your coverage begins.
How to find your current premium amounts
Medicare publishes updated premium and deductible amounts each fall for the following year. You can find the current amounts on Medicare.gov under "Costs at a Glance." Your Social Security statement also shows your Part B premium if you are already enrolled.
If you receive Social Security benefits, your Part B premium is deducted automatically from your monthly check. If you do not yet receive Social Security, you will receive a bill from Medicare each month. You can also call Social Security at 1-800-772-1213 to confirm your premium amount or ask about income-related adjustments.
Frequently Asked Questions
Do I have to pay Part A and Part B premiums at the same time?
If you receive Social Security, your Part B premium is deducted from your check automatically. Part A premiums (if you owe them) are billed separately by Medicare. You can arrange to pay Part A by mail, phone, or automatic bank withdrawal.
What happens if I cannot afford my Part B premium?
If your income is low, you may be able to get help through Medicaid or the Medicare Savings Program, which is run by your state. These programs can pay your Part B premium and deductible for you. Contact your state Medicaid office or call 1-800-Medicare to learn whether you may be may be able to access.
Can my Part B premium go down if my income drops?
Yes. If you had a major life change — such as retirement, loss of a spouse, or a significant drop in income — you can request a recalculation of your income-related adjustment. Submit a Life-Changing Event form to Social Security, and they will use your current income instead of the two-year-old tax return.
Does Medicare Part C or Part D have separate premiums?
Part C (Medicare Advantage) and Part D (prescription drug coverage) are optional. If you choose them, they have their own premiums set by private insurance companies, and these vary widely. You must be enrolled in Part A and Part B to join Part C, and Part D is separate.
What if I worked outside the United States — do those years count toward Part A?
Work in most countries does not count toward the 40 quarters needed for premium-free Part A. However, some countries have totalization agreements with the United States that allow certain work to count. Contact Social Security to verify whether your foreign work history qualifies.