Medicare costs vary by which parts you choose and your income level

Medicare has four parts, and each one costs differently. Part A (hospital insurance) is free for most people at 65 if they or their spouse paid Medicare taxes for at least 10 years. Part B (doctor visits and outpatient care) costs most people $164.90 per month in 2024, though higher earners pay more. Part D (prescription drugs) varies by plan, typically $7 to $100+ per month. Part C (Medicare Advantage) bundles A, B, and D into one plan and often costs $0 to $200+ per month, depending on the plan and your location.

Your actual monthly cost depends on three things: which parts you enroll in, whether you have other income or resources, and when you sign up. Signing up late can add permanent penalties to your monthly bill. Income also matters — if you earn above a certain threshold, you pay a higher Part B and Part D premium.

Key Takeaways

  • Part A is free for most people; Part B costs around $165 per month in 2024 for standard enrollees, but higher earners pay 35% to 85% more.
  • Part D prescription drug premiums range from under $10 to over $100 per month depending on the plan you choose and your location.
  • Medicare Advantage (Part C) plans often have $0 monthly premiums but may charge copays and deductibles when you use care.
  • Delaying enrollment past 65 adds a permanent 10% penalty to Part B and 1% per month to Part D for every year you wait.
  • If you earn more than $97,000 as a single filer or $194,000 as a couple, you pay higher premiums for Part B and Part D.

Part A and Part B premiums for 2024

Part A is free if you or your spouse worked and paid Medicare taxes for at least 10 years. If you do not meet that requirement, Part A costs $278 to $505 per month depending on how many quarters of coverage you have. Most people do not pay for Part A.

Part B costs $164.90 per month for most people in 2024. However, if your income from the previous year was above $97,000 (single) or $194,000 (married filing jointly), you pay more. The highest earners pay $560.50 per month for Part B. Your income threshold is based on your tax return from two years prior, so 2024 premiums reflect 2022 income.

You pay Part B premiums whether you use Medicare or not. If you delay enrolling in Part B past 65 without other coverage, you will owe a 10% penalty on your premium for each year you waited. That penalty is permanent and stays on your bill for life.

Part D prescription drug plan costs

Part D premiums depend entirely on which plan you choose and where you live. Plans are offered by private insurers and vary by region. A plan that costs $8 per month in one state might cost $25 in another. You can see all available plans and their premiums on Medicare.gov by entering your zip code.

In addition to the monthly premium, you also pay a deductible (usually $505 to $550 in 2024), then copays or coinsurance when you fill prescriptions. Once you spend $5,050 out of pocket in a year, you enter the "catastrophic" phase and pay only 5% of drug costs for the rest of the year.

If you do not enroll in Part D when you first become may be able to access at 65, you pay a 1% penalty on your premium for each month you delay. Unlike Part B, this penalty ends once you enroll, but it applies for as long as you stay in that plan.

Medicare Advantage (Part C) monthly costs

Medicare Advantage plans bundle Part A, Part B, and usually Part D into one plan offered by a private insurer. Many plans have $0 monthly premiums, which means you pay nothing on top of your Part B premium. However, you still owe your Part B premium to Medicare, and you may pay copays and deductibles when you use care.

Some Medicare Advantage plans do charge a monthly premium on top of Part B — anywhere from $50 to $200+ per month depending on the plan and your location. These plans often have lower copays or deductibles to offset the higher premium. Plans change every year, so a plan that cost $0 in one year might charge $50 the next year, or vice versa.

Medicare Advantage plans also include dental, vision, and hearing coverage that Original Medicare does not. This can save you money if you need those services, but it ties you to a network of doctors and hospitals. If you travel or see specialists outside the network, you may pay more or get no coverage.

Income-related premium adjustments (IRMAA)

If your income exceeds certain thresholds, Medicare charges you a higher premium for Part B and Part D. This is called an Income-Related Monthly Adjustment Amount, or IRMAA. The thresholds are $97,000 for single filers and $194,000 for married couples filing jointly in 2024. Income is measured using your tax return from two years prior.

For every income bracket above the threshold, your Part B premium increases. A single person earning $120,000 pays roughly $230 per month instead of $165. Someone earning $250,000 pays $560.50 per month. Part D premiums also increase by income bracket, typically adding $12 to $77 per month depending on how far above the threshold you are.

If your income drops due to retirement, job loss, or death of a spouse, you can request a Life Changing Event adjustment to lower your IRMAA. You must submit tax documents and a written request to Social Security within 60 days of the event.

Supplemental insurance (Medigap) costs

Original Medicare (Part A and B) does not cover everything. You still owe deductibles, copays, and coinsurance. Many people buy Medigap (supplemental insurance) to cover these gaps. Medigap premiums range from $100 to $300+ per month depending on which plan you choose and your age.

Medigap plans are standardized — Plan G in one state is the same as Plan G in another — but premiums vary by insurer and location. You can shop for Medigap plans on Medicare.gov or through private insurers. You have a six-month window after turning 65 and enrolling in Part B to buy Medigap without medical underwriting; after that window, insurers can deny you or charge more based on health.

If you have a Medicare Advantage plan, you cannot also have Medigap. You must choose one or the other.

When and how premiums are deducted

Part B and Part D premiums are usually deducted automatically from your Social Security check each month. If you do not receive Social Security, Medicare bills you directly. Part A has no premium for most people, so there is nothing to deduct.

If you enroll in Medicare Advantage or Medigap, those premiums are billed separately by the private insurer, not by Medicare. You receive a bill in the mail or can set up automatic payments with the insurer.

Your premiums can change each year. Medicare announces new premiums in October for the following year. If your income changes or you move to a different state, your costs may change mid-year.

Frequently Asked Questions

Do I have to pay for Part A?

Most people do not. Part A is free if you or your spouse paid Medicare taxes for at least 10 years. If you do not meet that requirement, Part A costs $278 to $505 per month depending on how many quarters of coverage you have. You can check your coverage record on ssa.gov.

What happens if I sign up for Medicare late?

You pay a permanent penalty on Part B (10% per year of delay) and Part D (1% per month of delay). These penalties stay on your bill for life. The only exception is if you had other health coverage, like employer insurance, when you turned 65. You have eight months after that coverage ends to enroll without penalty.

Can I change my Medicare plan if the cost goes up?

Yes. During the Annual Enrollment Period (October 15 to December 7 each year), you can switch to a different Part D plan, Medicare Advantage plan, or Medigap plan. If your income drops significantly, you can request a change outside this window by contacting Social Security.

Does Medicare cover everything once I pay my premiums?

No. Original Medicare (Part A and B) covers hospital and doctor visits but leaves you responsible for deductibles and coinsurance. Part D covers prescriptions but has a deductible and copays. Many people buy Medigap or choose Medicare Advantage to reduce out-of-pocket costs.

How do I know what my Part D premium will be?

Go to Medicare.gov and enter your zip code. You will see all available Part D plans, their monthly premiums, and which drugs they cover. Premiums change every year and vary by location, so check each year during open enrollment.