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. Part B (doctor visits and outpatient care) costs a monthly premium that changes each year — in 2025, the standard premium is $174.70 per month, though you may pay more if your income is above a certain level. Part D (prescription drugs) premiums vary by plan, typically ranging from $7 to $100+ per month. Part C (Medicare Advantage) is an alternative to Parts A and B offered by private insurers, with premiums that vary widely.

Beyond premiums, you also pay deductibles, copays, and coinsurance when you use care. These out-of-pocket costs add up differently depending on which parts you have and which plan you choose. Your actual total cost depends on how much medical care you use during the year.

Key Takeaways

  • Part A is free for most seniors; Part B costs $174.70 per month in 2025 for those with standard income levels.
  • Higher earners pay an additional income-related monthly adjustment amount (IRMAA) on top of the standard Part B premium.
  • Part D prescription drug premiums vary by plan and insurer, ranging from under $10 to over $100 monthly.
  • Deductibles, copays, and coinsurance are separate from premiums and depend on the type of care you receive and your specific plan.
  • Medicare Advantage plans (Part C) have their own premium structures and may offer lower out-of-pocket costs for some people.

Part B premiums and income-related charges

Part B covers doctor visits, lab work, imaging, and outpatient procedures. The standard monthly premium for 2025 is $174.70. However, if your modified adjusted gross income (MAGI) from two years prior exceeds certain thresholds, you pay an additional amount called the income-related monthly adjustment amount (IRMAA).

For 2025, IRMAA kicks in at different income levels depending on your filing status. Single filers with MAGI over $97,000 and married couples filing jointly with MAGI over $194,000 will pay more. The additional charge can range from $43.60 to $261.00 per month on top of the standard premium, depending on how far your income exceeds the threshold. Social Security will notify you if IRMAA applies to you.

You also pay a Part B deductible of $240 in 2025 before Medicare starts to pay. After that, you typically pay 20% of the cost for most services, while Medicare pays 80%.

Part D prescription drug costs

Part D is optional but recommended if you take regular medications. Premiums vary significantly by plan and insurer — some plans cost as little as $7 per month, while others exceed $100. The plan you choose affects both your monthly premium and your out-of-pocket costs when you fill prescriptions.

Part D also has an annual deductible, which can be up to $545 in 2025, though many plans have lower or no deductibles. Once you meet the deductible, you enter the initial coverage phase, where you pay a copay or coinsurance for each prescription. If your annual drug costs reach $5,850, you enter the coverage gap (sometimes called the "donut hole"), where you pay a higher percentage of drug costs. Once your out-of-pocket spending reaches $8,550, catastrophic coverage begins and your costs drop significantly.

IRMAA also applies to Part D. If your income exceeds the thresholds, you pay an additional monthly surcharge on top of your plan premium, ranging from $12.70 to $76.20 in 2025.

Medicare Advantage (Part C) premiums and out-of-pocket limits

Medicare Advantage plans are offered by private insurers and combine Parts A, B, and usually D into one plan. Premiums vary widely — some plans have $0 monthly premiums, while others charge $50 to $200+ per month. The trade-off is that Advantage plans typically have lower or no deductibles but higher copays and coinsurance when you use care.

Medicare Advantage plans have an annual out-of-pocket maximum, which in 2025 cannot exceed $8,550 for in-network care. Once you reach this limit, the plan pays 100% of your in-network costs for the rest of the year. This can be helpful if you expect significant medical expenses, because your total spending is capped.

However, Advantage plans often require you to use doctors and hospitals within their network. Out-of-network care may cost more or not be covered at all. Some plans also require prior authorization for certain procedures, which can delay care.

Medigap (supplemental insurance) costs

Medigap policies are sold by private insurers and help pay the costs that Original Medicare (Parts A and B) doesn't cover — deductibles, copays, and coinsurance. Medigap is separate from Medicare Advantage; you cannot have both at the same time.

Medigap premiums depend on the plan letter you choose (Plan A, B, C, D, and so on), your age, your location, and the insurance company. Premiums typically range from $100 to $300+ per month, though some plans cost more. Younger retirees generally pay less than older ones for the same plan. You can enroll in Medigap during your initial enrollment period or during the annual open enrollment period, though some states allow enrollment outside these windows.

If you have Medigap, you still pay Part B and Part D premiums separately, plus any IRMAA charges. Medigap does not cover prescription drugs, so you still need Part D.

How to estimate your total 2025 Medicare costs

Your total Medicare cost depends on which parts you choose and how much care you use. Start by adding up your premiums: Part B ($174.70 standard, plus any IRMAA), Part D (varies by plan), and any Medigap or Advantage premium. Then estimate your deductibles and copays based on the care you expect to need.

If you have Original Medicare with Medigap, your out-of-pocket costs are more predictable because Medigap covers most deductibles and copays. If you have Original Medicare without Medigap, you pay 20% coinsurance after the deductible. If you have Medicare Advantage, your costs are capped at the annual out-of-pocket maximum, but you may pay more upfront in copays.

Medicare.gov has a plan finder tool where you can enter your medications and doctors to compare plans side by side and see estimated costs. Your local Area Agency on Aging also offers free counseling to help you compare options.

Income-related charges (IRMAA) explained

IRMAA is an extra charge added to your Part B and Part D premiums if your income is above a certain level. Medicare uses your modified adjusted gross income (MAGI) from two years before the current year to calculate IRMAA. For 2025 coverage, Medicare looks at your 2023 tax return.

The income thresholds for 2025 are $97,000 for single filers and $194,000 for married couples filing jointly. If your income exceeds these amounts, you pay additional monthly charges. The more your income exceeds the threshold, the higher the surcharge. You can request a recalculation if your income dropped significantly due to retirement, job loss, or divorce.

IRMAA applies to Part B, Part D, and Part C (Medicare Advantage) premiums. It does not explore to Medigap. If you disagree with the IRMAA amount, you can appeal to Social Security.

Frequently Asked Questions

Do I have to pay for Part A?

Most people do not pay a Part A premium because they or their spouse paid Medicare taxes while working. However, if you do not have 40 quarters of Medicare tax credits, you may have to pay a premium. In 2025, the Part A premium ranges from $278 to $556 per month depending on your work history. Contact Social Security to learn about you owe a Part A premium.

What if my income changes after I enroll?

If your income drops significantly — for example, because you retired or lost a job — you can request that Social Security recalculate your IRMAA. You will need to provide documentation of the income change. If approved, your new IRMAA will take effect the following month.

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

Yes. You can change Part D plans or switch to a different Medicare Advantage plan during the annual open enrollment period, which runs October 15 to December 7 each year. Changes take effect January 1. If you have a may have access to life event (such as loss of employer coverage), you may be able to change plans outside the open enrollment window.

Does Medicare cover dental, vision, or hearing?

Original Medicare does not cover routine dental, vision, or hearing care. However, some Medicare Advantage plans include these benefits. If these services matter to you, compare Advantage plans that offer them, or purchase standalone dental and vision insurance.

What is the difference between the coverage gap and catastrophic coverage?

The coverage gap occurs after you and your plan have spent $5,850 on covered drugs in 2025. During the gap, you pay a higher percentage of drug costs. Catastrophic coverage begins once your out-of-pocket spending reaches $8,550. After that, you pay only a small copay or coinsurance for the rest of the year.