Medicare Part A and Part B premiums, deductibles, and copays
Most people do not pay a monthly premium for Medicare Part A (hospital insurance) if they or their spouse paid Medicare taxes for at least 10 years while working. If you do not meet that requirement, the premium ranges from roughly $278 to $556 per month, depending on how many quarters of coverage you have.
Medicare Part B (medical insurance) costs a monthly premium that changes each year. For 2024, the standard premium is $164.90 per month for most people, though you may pay more if your income was above certain thresholds two years prior. Beyond the monthly premium, Part B has an annual deductible of $240 and then you pay 20 percent of the cost for most services after that.
Part A also has costs beyond the premium. If you are admitted to a hospital, you pay a deductible of $1,632 per benefit period in 2024. For skilled nursing facility care, you pay nothing for the first 20 days, then up to $408 per day for days 21 through 100. Hospice and home health care under Part A typically have no copay.
Key Takeaways
- Most people pay no monthly premium for Part A if they worked and paid Medicare taxes for at least 10 years, but you will pay a hospital deductible of $1,632 per benefit period if admitted.
- Part B costs $164.90 per month in 2024 for most people, plus a $240 annual deductible, then 20 percent coinsurance for most services.
- Your Part B premium may be higher if your income two years ago exceeded $97,000 (single) or $194,000 (married filing jointly).
- Part A and Part B do not cover everything — dental, vision, hearing aids, and long-term care are not included, and you may want to consider a Medigap or Medicare Advantage plan to cover gaps.
Who pays a Part A premium and how much
You pay no monthly premium for Part A if you or your spouse paid Medicare taxes for at least 40 quarters (10 years) while working. This covers the vast majority of people who reach age 65. If you have fewer than 40 quarters of coverage, you can still enroll, but you will pay a premium.
The Part A premium for someone with 30 to 39 quarters of coverage is $278 per month in 2024. If you have fewer than 30 quarters, the premium is $556 per month. These amounts change annually. You can check your own work history by creating an account at ssa.gov and viewing your Social Security statement, which shows your quarters of coverage.
If you are already receiving Social Security retirement or disability benefits when you turn 65, Medicare Part A is enrolled automatically. If you are not yet receiving benefits, you must enroll during your initial enrollment period, which begins three months before the month you turn 65 and ends three months after.
Part B premiums and income-related adjustments
The standard Part B premium for 2024 is $164.90 per month. However, if your modified adjusted gross income (MAGI) from two years prior was above certain thresholds, you will pay a higher premium through an Income-Related Monthly Adjustment Amount (IRMAA).
For 2024, if you are single and your 2022 MAGI was above $97,000, your Part B premium increases. The brackets go up to $560.50 per month for those with MAGI above $500,000. If you are married filing jointly, the thresholds start at $194,000 and reach the highest bracket at $750,000 or more. The Social Security Administration uses your tax return from two years prior, so changes in your income take time to show up in your premium.
You can request a reconsideration of your IRMAA if your income dropped significantly due to retirement, death of a spouse, or loss of income-producing property. You must file this request within 60 days of receiving your premium notice.
Part A deductibles and copays for hospital and skilled nursing care
When you are admitted to a hospital under Part A, you pay a deductible of $1,632 per benefit period in 2024. A benefit period begins the day you enter the hospital and ends 60 days after you leave without receiving any inpatient hospital or skilled nursing facility care. If you are readmitted after that 60-day gap, a new benefit period starts and you pay the deductible again.
For days 1 through 60 of a hospital stay, you pay nothing after the deductible. For days 61 through 90, you pay $408 per day. If you stay longer than 90 days, you can use lifetime reserve days — you have 60 of these over your lifetime, and they cost $816 per day. After your lifetime reserve days are exhausted, you pay the full cost of hospital care.
If you move to a skilled nursing facility after a hospital stay, you pay nothing for the first 20 days. For days 21 through 100, you pay $204 per day in 2024. After day 100, you pay all costs. Part A covers skilled nursing care only if you were hospitalized for at least three consecutive days first and enter the facility within 30 days of leaving the hospital.
Part B deductibles and coinsurance for doctor visits and outpatient services
Part B has an annual deductible of $240 in 2024. You must pay this amount out of pocket before Medicare begins to pay its share. Once you have met the deductible, Medicare typically pays 80 percent of the approved amount for most services, and you pay the remaining 20 percent as coinsurance.
This 80/20 split applies to doctor visits, lab tests, imaging, outpatient surgery, and most other Part B services. However, some services have different cost-sharing: preventive care such as screenings, vaccines, and annual wellness visits are covered at no cost after you meet the deductible. Mental health services and physical therapy have the same 20 percent coinsurance.
If your doctor does not accept Medicare assignment (meaning they do not agree to the Medicare-approved amount), you may pay more. Doctors who do not accept assignment can charge up to 15 percent above the Medicare-approved amount, and you are responsible for the difference. Always ask whether your doctor accepts Medicare assignment before your visit.
What Part A and Part B do not cover
Original Medicare (Part A and Part B together) does not cover dental care, vision exams, eyeglasses, hearing aids, or routine foot care. It also does not cover long-term care in a nursing home or assisted living facility — Part A covers only skilled nursing care for a limited time after hospitalization. Prescription drugs are not covered by Part A or Part B; you need Part D for that.
Many people buy a Medigap policy (also called Supplement insurance) to cover the gaps left by Part A and Part B, such as deductibles and coinsurance. Alternatively, you can enroll in a Medicare Advantage plan (Part C), which is an all-in-one alternative to Original Medicare that often includes prescription drug coverage and sometimes dental or vision benefits, though usually with higher copays and network restrictions.
You can also purchase standalone Part D plans for prescription drug coverage if you stay with Original Medicare. The cost of Part D premiums and coverage varies by plan and changes annually.
How costs change year to year
Medicare premiums, deductibles, and coinsurance amounts are adjusted each year based on inflation and program costs. The Centers for Medicare and Medicaid Services (CMS) announces the new amounts in the fall, and they take effect on January 1. The Part B premium and deductible are often the most visible changes from year to year.
Your Part B premium notice arrives in December, showing your 2024 premium and any IRMAA adjustment. If you disagree with the amount, you have until the end of February to request a reconsideration. Changes to Part A costs are less common but do occur — the hospital deductible and skilled nursing facility copay are adjusted annually.
Frequently Asked Questions
Do I have to pay for Part A if I did not work long enough?
If you have fewer than 40 quarters of coverage, you can still enroll in Part A, but you will pay a monthly premium ranging from $278 to $556 depending on your work history. Some people choose not to enroll if the premium is high and they have other coverage through a spouse's plan.
Can I reduce my Part B premium if my income dropped?
Yes. If your income decreased significantly due to retirement, death of a spouse, or loss of income-producing property, you can request a reconsideration of your IRMAA within 60 days of receiving your premium notice. You will need to provide documentation of the change.
What happens if I do not pay my Part B premium?
If you do not pay your Part B premium, your coverage will be terminated. You can re-enroll during the General Enrollment Period (January 1 through March 31 each year), but you may face a permanent late enrollment penalty of 10 percent added to your premium for each year you were not enrolled.
Are preventive services really free under Part B?
Yes, preventive services covered by Part B — such as annual wellness visits, cancer screenings, vaccines, and cardiovascular screenings — are covered at no cost after you meet your deductible. However, if your doctor finds a problem during a preventive visit and performs additional diagnostic tests, those tests may be subject to the 20 percent coinsurance.
Should I get a Medigap plan or Medicare Advantage?
Medigap covers the gaps in Original Medicare (deductibles, coinsurance) but does not include prescription drugs or dental. Medicare Advantage is an all-in-one alternative that often includes drug coverage and extra benefits, but usually has higher copays and requires using in-network providers. The right choice depends on your health needs, budget, and preferred doctors.