Medicare premiums vary by the type of coverage you choose and your income

Medicare has different parts, and each one has its own monthly cost. Part A (hospital insurance) is free for most people who paid Medicare taxes while working. Part B (doctor visits and outpatient care) costs most people $164.90 per month in 2024, though the amount changes each year. Part D (prescription drugs) varies widely depending on which plan you pick — anywhere from roughly $7 to $100+ per month. If you choose Part C (Medicare Advantage, an all-in-one alternative), the premium depends entirely on the insurance company offering it.

Your actual out-of-pocket cost also depends on your income. If you earn more than a certain amount, you pay a higher premium for Part B and Part D — this is called an Income-Related Monthly Adjustment Amount, or IRMAA. The income thresholds and surcharge amounts change yearly, so what you paid last year may not be what you pay this year.

Key Takeaways

  • Part A (hospital) is free for most people; Part B (doctor visits) costs around $164.90 per month in 2024, but the amount increases each January.
  • Part D (prescription drugs) premiums range widely by plan and insurer, from under $10 to over $100 monthly.
  • If your income exceeds certain thresholds, you pay an additional surcharge on top of your Part B and Part D premiums.
  • Medicare Advantage (Part C) premiums vary by plan and insurer, and some plans charge $0 monthly premium.
  • Your premium amount is set each year and takes effect on January 1, so check your notice in the mail each fall.

Part A: Hospital Insurance Costs

Most people who worked and paid Medicare taxes for at least 10 years pay nothing for Part A. If you did not work long enough, you can buy Part A coverage, but the premium is steep — in 2024, it ranges from roughly $278 to $556 per month depending on how many quarters of work history you have.

Even though Part A is free, you still pay out-of-pocket costs when you use it. You pay a deductible (a set amount before insurance kicks in) for each hospital stay, and you may pay daily copayments if your stay is longer than a certain number of days. These costs are separate from your premium.

Part B: Doctor Visits and Outpatient Care

Part B covers doctor visits, lab tests, imaging, and outpatient procedures. The standard premium for 2024 is $164.90 per month for most people, but this amount increases each year. You pay this premium whether you use Medicare or not.

Part B also has a yearly deductible (currently $240 in 2024) that you must meet before Medicare starts paying its share. After you meet the deductible, you typically pay 20% of the cost for most services, and Medicare pays 80%.

If you delay signing up for Part B when you first become may be able to access at 65, you may face a permanent penalty — your premium goes up by 10% for each 12-month period you were may be able to access but did not enroll. The only exceptions are if you had employer coverage or certain other circumstances.

Part D: Prescription Drug Coverage

Part D premiums depend on which plan you choose and which insurance company offers it. Plans are ranked by cost, and you can find plans ranging from roughly $7 to $100+ per month. The plans also differ in which drugs they cover and how much you pay out-of-pocket for each one.

You do not have to pick the cheapest plan — you can choose any plan available in your area. However, if you go without Part D coverage when you first become may be able to access, you pay a penalty for each month you were not enrolled. The penalty is added to your Part D premium permanently, even if you sign up later.

Part D premiums and drug coverage change every year on January 1. Insurance companies can add or drop drugs from their formulary (the list of covered medications), and they can change the copayment amounts. You can switch to a different Part D plan once a year during the annual enrollment period in the fall.

Part C: Medicare Advantage Plans

Medicare Advantage (Part C) is an alternative way to get your Part A and Part B coverage through a private insurance company instead of traditional Medicare. Some Medicare Advantage plans charge $0 monthly premium, while others charge $50 to $200+ per month depending on the plan and insurer.

Most Medicare Advantage plans include Part D (prescription drug coverage) built in, so you do not pay a separate Part D premium. However, you typically pay higher copayments and deductibles when you use the plan compared to traditional Medicare. Many plans also limit you to a network of doctors and hospitals.

Medicare Advantage plans change their premiums and coverage every year. You can switch plans once a year during the annual enrollment period, which runs from October 15 to December 7.

Income-Related Surcharges (IRMAA)

If your income is above a certain threshold, you pay more for Part B and Part D. This extra charge is called an Income-Related Monthly Adjustment Amount. The income thresholds are based on your modified adjusted gross income from two years prior — so in 2024, Medicare looks at your 2022 tax return.

The surcharge can be substantial. For example, in 2024, a single person with income over $103,000 pays an additional amount on top of the standard Part B premium. A married couple filing jointly with income over $206,000 faces the same surcharge. The higher your income, the higher the surcharge, with the maximum surcharge being several hundred dollars per month.

If your income drops due to a life event — such as retirement, death of a spouse, or loss of a job — you can request that Medicare recalculate your IRMAA using your current year income instead of the prior year's. You must file a form called the Medicare Income-Related Monthly Adjustment Amount — Life-Changing Event within 60 days of the event.

When and How Premiums Are Deducted

If you receive Social Security benefits, your Part B and Part D premiums are automatically deducted from your monthly Social Security payment. If you do not receive Social Security, Medicare sends you a bill each month, and you pay by mail or online.

Your premium amount is set each year and takes effect on January 1. In the fall (usually October or November), you receive a notice in the mail showing your premiums for the coming year. Review this notice carefully — if your income has changed or if you think the amount is wrong, contact Social Security or Medicare to correct it before January 1.

Frequently Asked Questions

Do I have to pay for Part A if I worked less than 10 years?

Yes, you can buy Part A coverage if you did not work long enough to may have access to for free coverage. The monthly premium ranges from roughly $278 to $556 in 2024, depending on how many quarters of work history you have. You can enroll in Part A during your initial enrollment period or during the general enrollment period.

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

You face a permanent penalty on your premium for each month you were may be able to access but did not enroll. The Part B penalty is 10% of the standard premium for each 12-month period you were not enrolled. The Part D penalty is roughly 1% of the national average Part D premium for each month you were not enrolled. These penalties stay with you for life, even if you sign up later.

Can I change my Part D plan if my medications are no longer covered?

Yes, you can switch to a different Part D plan during the annual enrollment period (October 15 to December 7) each year. You can also request a special enrollment period if your plan drops a drug you take or if you move out of your plan's service area. Contact your current plan or Medicare to find out which other plans cover your medications.

Will my premium go down if my income decreases?

Your premium is based on your income from two years prior, so it does not automatically adjust when your income drops. However, if you have a major life event — such as retirement, death of a spouse, or loss of employment — you can request that Medicare recalculate your IRMAA using your current year income. You must file the request within 60 days of the event.

Are there any programs that help pay Medicare premiums?

Yes. The Medicare Savings Program helps pay Part B and Part D premiums (and sometimes deductibles and copayments) for people with limited income and resources. may be able to access and benefits vary by state. You can find your state program by calling 1-800-MEDICARE or visiting Medicare.gov. Some people may also may have access to for Extra Help, a federal program that reduces Part D costs.