Medicare Part A and Part B costs in 2024

Medicare Part A (hospital insurance) costs most people nothing per month 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 $557, depending on how many years you paid in.

Medicare Part B (medical insurance) costs most people $174.70 per month in 2024, though the amount changes each year. If your income is higher, you pay more — the extra charge is called an Income-Related Monthly Adjustment Amount, or IRMAA. People with annual income above $97,000 (single) or $194,000 (married filing jointly) pay between $244.60 and $560.50 per month for Part B.

These amounts are what the government sets. Your actual bill depends on your work history, your current income, and whether you signed up on time. If you delayed signing up for Part B without a valid reason, you may pay a permanent 10 percent penalty on top of the standard premium.

Key Takeaways

  • Most people pay nothing for Part A if they worked and paid Medicare taxes for at least 10 years, but those who did not may pay $278 to $557 per month.
  • Part B costs $174.70 per month for most people in 2024, but rises to $244.60 to $560.50 per month if your income is above certain thresholds.
  • Your income from the prior year (two years back) determines whether you pay the extra IRMAA charge, not your current income.
  • Late sign-up penalties for Part B are permanent and add 10 percent to your premium for each year you delayed without a valid reason.

How Part A premiums work if you did not work long enough

Part A is free for most people because they paid the Medicare tax (called the Hospital Insurance tax) throughout their working years. You need 40 quarters of coverage — roughly 10 years of work — to may have access to for premium-free Part A at age 65.

If you have fewer than 40 quarters, you still may enroll in Part A, but you will pay a monthly premium. In 2024, the premium is $278 per month if you have 30 to 39 quarters of coverage. If you have fewer than 30 quarters, the premium is $557 per month. These amounts increase each year along with the cost of living.

You can check your work history and quarters of coverage on your Social Security account at ssa.gov. Log in, go to "Earnings Record," and count the years listed. Each year you earned at least $1,632 in covered wages counts as one quarter.

How Part B premiums change based on your income

Part B has a standard premium that most people pay. In 2024, that amount is $174.70 per month. But if your income is above a certain level, Medicare adds an extra charge called IRMAA.

The income thresholds are $97,000 per year for single filers and $194,000 for married couples filing jointly. These thresholds do not change year to year. If your income is above them, you move into a higher bracket and pay more. The brackets range from $97,001 to $610,000 for single filers, with Part B premiums rising from $244.60 to $560.50 per month.

Medicare uses your tax return from two years before the current year to calculate IRMAA. So in 2024, they look at your 2022 income. This matters if your income dropped recently — you can report a life-changing event (like retirement, loss of a spouse, or loss of income) to ask Medicare to use your current year's income instead. You have 60 days from the event to report it.

When you pay Part A and Part B premiums

If you receive Social Security benefits, Medicare automatically deducts Part A and Part B premiums from your monthly check. Most people do not see a separate bill — the amount straightforward comes out before you receive your payment.

If you do not yet receive Social Security, or if you receive it but Medicare cannot deduct from it, Medicare sends you a bill each month. You can pay by mail, phone, or online at Medicare.gov. Payments are due by the 30th of each month.

Part A and Part B premiums are separate from your deductible and copayments. The premium is what you pay to have the coverage. The deductible is what you pay before Medicare starts to help, and copayments are what you pay when you use a service.

Late enrollment penalties and how they work

If you delay signing up for Part B after you turn 65, and you do not have a valid reason, Medicare charges a permanent penalty. The penalty is 10 percent of the standard Part B premium for each full year you were late. If you delayed for three years, you pay 30 percent extra on top of the standard premium — and you keep paying that extra amount for as long as you have Part B.

Valid reasons to delay without penalty include having employer health insurance through your job or your spouse's job, or being a federal employee with health coverage. If you had one of these, you have eight months after your coverage ends to sign up for Part B without penalty.

Part A does not have a late enrollment penalty if you enroll within six months of losing employer coverage. But Part B penalties are permanent, so it is important to sign up on time or confirm you have a valid reason to delay.

What to ask your doctor or Medicare representative

Before you turn 65, contact Social Security to confirm your work history and quarters of coverage. Ask whether you will may have access to for premium-free Part A. If you will not, ask what your Part A premium will be.

If your income is high, ask Medicare whether you will pay IRMAA and how much. You can call Medicare at 1-800-MEDICARE (1-800-633-4227) and speak to a representative who can look up your income and tell you your exact Part B premium.

If you have employer health insurance and plan to retire, ask your employer's benefits office when your coverage ends. Write down the exact date, because you will have eight months from that date to sign up for Part B without penalty.

Frequently Asked Questions

Can I change my mind about Part B if I signed up late and now have a penalty?

No, the penalty is permanent once it is applied. However, if you can show that you had a valid reason to delay (such as employer coverage), you can ask Medicare to remove the penalty. You have a limited time to appeal, so contact Medicare right away if you believe the penalty was applied in error.

Does my spouse's income affect what I pay for Part B?

Yes, if you are married and file taxes jointly, Medicare uses your combined household income to calculate IRMAA. If you file separately, Medicare uses only your individual income. Some couples find that filing separately lowers their Part B premium, though it may affect other tax benefits.

What happens if I cannot afford my Part B premium?

You may be able to get help paying premiums through Medicaid or a Medicare Savings Program run by your state. These programs pay Part A and Part B premiums, deductibles, and copayments for people with limited income. Contact your state Medicaid office or call 1-800-MEDICARE to ask about programs in your area.

Do Part A and Part B premiums go up every year?

Part A and Part B premiums increase most years based on the rise in healthcare costs. The exact amount of the increase is announced in the fall for the following year. You will receive a notice in the mail showing your new premium amount before it takes effect.

If I work past 65, do I still have to pay for Part B?

If you are still covered by your employer's health plan, you can delay Part B without penalty. Once you leave that job or lose the coverage, you have eight months to sign up. If you do not sign up within that window, the 10 percent annual penalty applies.