Medicare has four parts, and each one costs differently

Medicare Part A (hospital insurance) is free for most people 65 and older who paid Medicare taxes while working. You do not pay a monthly premium, but you do pay a deductible when you go to the hospital — currently $1,676 per benefit period. A benefit period starts when you enter the hospital and ends 60 days after you leave.

Medicare Part B (medical insurance for doctor visits and outpatient care) costs a monthly premium. For 2025, the standard premium is $185 per month, though you may pay more if your income was high two years ago. You also pay a $240 annual deductible, then 20% of the cost of most services after that.

Medicare Part D (prescription drug coverage) is optional and costs vary by plan — typically $5 to $100 per month. You choose a plan from private insurers, and the premium, deductible, and drugs covered differ by plan and by year. Medicare Part C (Medicare Advantage) is an alternative to Parts A and B sold by private insurers. It bundles hospital and medical coverage into one plan with its own costs — usually a lower or zero premium but higher out-of-pocket limits.

Your actual costs depend on which parts you have, which plan you choose, how much medical care you use, and your income level. Income affects Part B and Part D premiums through something called Income-Related Monthly Adjustment Amounts (IRMAA).

Key Takeaways

  • Part A is free for most people, but you pay $1,676 per hospital stay; Part B costs $185 monthly in 2025 plus a $240 deductible and 20% of services.
  • Part D (drug coverage) premiums range from $5 to $100 per month depending on the plan you choose, and you can change plans every year.
  • If your income was over $103,000 as a single person two years ago, you will pay extra on top of the standard Part B and Part D premiums.
  • Medicare Advantage (Part C) is sold by private companies and may have lower premiums but higher costs when you use care.
  • You can change your coverage during the annual enrollment period from October 15 to December 7 each year.

Part A costs: hospital deductibles and copays

Part A covers inpatient hospital stays, skilled nursing facility care, hospice, and some home health services. Most people pay nothing for the Part A premium because they or their spouse paid Medicare taxes for at least 10 years while working.

What you do pay is the deductible: $1,676 for each benefit period in 2025. A benefit period is not a calendar year — it runs from the day you enter the hospital until 60 days pass without a hospital or skilled nursing stay. If you go back to the hospital after those 60 days, a new benefit period starts and you pay the deductible again.

After you pay the deductible, Part A covers all hospital costs for days 1 through 60. Days 61 through 90 cost you $419 per day (coinsurance). Days 91 and beyond cost $838 per day, up to a lifetime reserve of 60 additional days. Skilled nursing facility care costs you nothing for days 1 through 20, then $209.50 per day for days 21 through 100.

Part B costs: doctor visits and outpatient services

Part B covers doctor visits, lab tests, imaging, outpatient surgery, and durable medical equipment. The standard monthly premium for 2025 is $185, but this rises if your income was high two years ago. The annual deductible is $240, and after you meet it, Medicare pays 80% of the approved amount for most services — you pay 20%.

Some services have different cost-sharing rules. Mental health visits, for example, follow the 20% coinsurance after the deductible. Preventive services like annual wellness visits, cancer screenings, and vaccines are covered at no cost after you meet the deductible.

If a doctor does not accept Medicare assignment (meaning they do not agree to accept Medicare's approved amount as payment in full), you may owe more than 20%. This is called balance billing. You can call the doctor's office before your visit to ask whether they accept assignment.

Part D costs: prescription drug coverage

Part D is optional, but if you do not sign up when you first become may be able to access and you go without coverage, you pay a penalty for as long as you have Medicare. The penalty is roughly 1% of the national average Part D premium per month you were uninsured, added to your premium permanently.

Part D premiums vary by plan and insurer — they range from about $5 to $100 per month. After you pay the premium, you typically pay a deductible (usually $0 to $545 in 2025), then a copay or coinsurance for each drug. The amount you pay depends on which "tier" the drug is on — generic drugs cost less than brand-name drugs.

Part D has a coverage gap called the "donut hole." Once you and your plan have spent $5,850 on 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 only a small copay. The exact amounts change each year.

Income-based premiums: IRMAA explained

If your income was above a certain level two years ago, you pay more for Part B and Part D. This extra charge is called IRMAA. For 2025, if you filed taxes as a single person and your income was over $103,000, you owe extra. For married couples filing jointly, the threshold is $206,000.

The extra amount depends on how much your income exceeded the threshold. It can range from $70 to $560 per month for Part B and $12 to $77 per month for Part D. Medicare calculates IRMAA based on your tax return from two years prior, so 2025 premiums are based on your 2023 income.

If your income dropped significantly — because you retired, lost a job, or had a major life change — you can ask Medicare to recalculate your IRMAA using your current year's income. You will need to file a form and provide proof of the change. Contact Social Security at 1-800-772-1213 to request this.

Medicare Advantage (Part C) costs

Medicare Advantage is an alternative to Original Medicare (Parts A and B). Private insurers offer these plans, and they bundle hospital and medical coverage together. Many have zero monthly premiums, though some charge $50 to $200 per month. You still pay the Part B premium to Medicare.

The trade-off is that Medicare Advantage plans have networks — you usually must see doctors in the plan's network, or pay more. They also have out-of-pocket maximums, typically $7,550 to $10,000 per year. Once you hit that limit, the plan pays 100% of covered services for the rest of the year.

Most Medicare Advantage plans include Part D drug coverage, so you do not buy it separately. However, you should compare the plan's drug formulary (the list of covered drugs) against the medications you actually take before you enroll.

Medigap (supplemental insurance) costs

Medigap is private insurance that covers some of the costs Medicare does not — like deductibles, coinsurance, and copays. It is different from Medicare Advantage. Medigap works alongside Original Medicare (Parts A and B), and you buy it from a private insurer.

Medigap premiums vary widely by plan type, insurer, your age, and your location. A basic plan might cost $100 to $150 per month, while a more comprehensive plan could cost $250 to $400 per month. There are 10 standardized Medigap plans (labeled A through N), and each covers a different set of costs.

You have a six-month open enrollment period starting the month you turn 65 and enroll in Part B. During this window, insurers cannot deny you coverage or charge more based on your health. If you miss this window, you may face higher premiums or denial of coverage.

How to estimate your total Medicare costs

Your total annual cost depends on which parts you have and how much care you use. A rough estimate for someone with Original Medicare and no Medigap: Part B premium ($185/month = $2,220/year), Part D premium ($30 to $50/month = $360 to $600/year), Part B deductible ($240), and 20% of services after that. If you use minimal care, you might spend $3,000 to $4,000 per year. If you have a hospital stay, you add the Part A deductible ($1,676) and potentially more.

If you choose Medicare Advantage with zero premium, you may pay less upfront, but you could pay more when you use services because of copays and network restrictions. If you add Medigap, your premium rises by $100 to $400 per month, but your out-of-pocket costs for services drop significantly.

The best way to compare is to list the medications you take and the doctors you see, then get quotes from plans in your area. Medicare.gov has a plan comparison tool, and you can also call 1-800-MEDICARE to speak with someone who can walk you through options.

Frequently Asked Questions

Do I have to pay for Part A if I did not work long enough?

If you or your spouse did not pay Medicare taxes for at least 10 years, you can still get Part A, but you will pay a premium. The premium in 2025 is $278 per month if you have 30 to 39 quarters of coverage, or $505 per month if you have fewer than 30 quarters. You can check your work history at ssa.gov.

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

If you delay Part B without a valid reason, you pay a penalty of 10% of the standard premium for each year you were uninsured, added to your premium permanently. You can sign up during the General Enrollment Period (January 1 to March 31), but the penalty applies unless you had employer coverage or another valid reason for the delay.

Can I change my Medicare plan if I realize I chose the wrong one?

Yes, during the Annual Enrollment Period (October 15 to December 7), you can switch between Original Medicare and Medicare Advantage, change Medigap plans, or change Part D plans. Changes take effect January 1. Outside this window, you can only change if you have a may have access to life event like moving, losing employer coverage, or becoming may be able to access for Medicaid.

Does Medicare cover dental, vision, or hearing?

Original Medicare does not cover routine dental, vision, or hearing care. Some Medicare Advantage plans include these benefits, though usually with limits. You can buy standalone dental, vision, or hearing plans, or check whether you may have access to for Medicaid, which may cover these services depending on your state.

What if I cannot afford my Medicare premiums?

If your income is low, you may may have access to for programs like the Medicare Savings Program (which helps pay Part B and Part D premiums) or Extra Help (which helps with Part D costs). Contact your state Medicaid office or call 1-800-MEDICARE to learn whether you may have access to.