The basic monthly costs depend on which parts you choose

Medicare has different pieces, and each one costs something different. Part A (hospital insurance) usually costs nothing if you or your spouse paid Medicare taxes for at least 10 years while working. Part B (doctor visits and outpatient care) costs most people around $165 to $560 per month in 2024, depending on your income. Part D (prescription drugs) varies widely by plan and what drugs you take. Part C (Medicare Advantage) is an alternative to Parts A and B, offered by private insurers, and costs vary by plan and location.

The amount you pay changes every year. Medicare sets new Part B and Part D costs each January. If your income is higher, you pay more — this is called an Income-Related Monthly Adjustment Amount, or IRMAA. The Social Security Administration calculates this based on your tax return from two years ago.

Beyond the monthly premium, you also pay when you actually use care. This includes deductibles (the amount you pay before Medicare starts paying), copays (a fixed amount per visit), and coinsurance (a percentage of the cost). These out-of-pocket costs add up differently depending on which plan you choose.

Key Takeaways

  • Part A usually has no monthly premium if you worked and paid Medicare taxes for at least 10 years.
  • Part B costs roughly $165 to $560 per month depending on your income, and the amount changes each January.
  • If your income is above a certain threshold, you pay an extra amount called IRMAA on top of your regular premium.
  • You also pay deductibles, copays, and coinsurance when you use care, which vary by the plan you choose.
  • Part D (drug coverage) and Part C (Medicare Advantage) costs depend on the specific plan and your location.

Part A: Hospital insurance and what it covers

Part A covers hospital stays, skilled nursing facility care, hospice, and some home health services. Most people pay nothing monthly because they earned it through payroll taxes during their working years. You need 40 quarters (10 years) of work history to get premium-free Part A.

If you do not have 40 quarters, you can still buy Part A. The monthly cost in 2024 is around $505 if you have 30 to 39 quarters, or around $1,015 if you have fewer than 30 quarters. These amounts change yearly.

Even with Part A, you pay when you use it. In 2024, you pay a $1,676 deductible for each hospital stay. After that, you pay coinsurance — nothing for days 1 through 60, then $419 per day for days 61 through 90, and $838 per day for days 91 and beyond (up to 60 lifetime reserve days). Skilled nursing facility care has its own deductible and coinsurance structure.

Part B: Doctor visits and outpatient services

Part B covers doctor visits, lab tests, imaging, outpatient surgery, and durable medical equipment like wheelchairs and oxygen. Almost everyone on Medicare pays a monthly Part B premium. The standard amount in 2024 is $175.10, but your actual cost depends on your income.

If your modified adjusted gross income (MAGI) from two years ago exceeds certain thresholds, you pay more. For someone filing single taxes, the thresholds start at $97,000. For married couples filing jointly, they start at $194,000. The higher your income above these thresholds, the more you pay — up to about $560 per month for the highest earners.

You also pay when you use Part B services. There is a $240 annual deductible in 2024. After you meet it, you typically pay 20 percent coinsurance for most services. For office visits, you might pay a copay instead — usually $15 to $50 depending on the type of visit.

Part D: Prescription drug coverage costs

Part D is optional but important if you take medications. You choose a plan from private insurers, and each plan has a different monthly premium, deductible, and list of covered drugs. Premiums range from roughly $7 to $100 per month depending on the plan and your location.

When you fill a prescription, you pay a copay or coinsurance. The amount depends on which "tier" the drug is on — generic drugs cost less, brand-name drugs cost more. Most plans have a deductible you meet first, usually $35 to $545 per year.

There is also a coverage gap called the "donut hole." Once you and your plan have spent a certain amount on drugs (around $5,850 in 2024), you enter the gap and pay more out of pocket until you reach catastrophic coverage. After that, you pay a small copay or coinsurance and Medicare covers the rest.

Part C: Medicare Advantage as an alternative

Medicare Advantage (Part C) is a private insurance option that replaces Original Medicare (Parts A and B). You still pay your Part B premium, but then you choose a Medicare Advantage plan from an insurer. The plan's premium varies — some have no premium at all, while others charge $50 to $200 per month.

Medicare Advantage plans often include Part D drug coverage built in, so you do not buy it separately. They also typically have lower out-of-pocket costs than Original Medicare — many cap your annual spending. However, you must use doctors and hospitals in the plan's network, and you may need referrals to see specialists.

The trade-off is convenience and cost predictability versus flexibility. If you travel frequently or want to see any doctor who accepts Medicare, Original Medicare may suit you better. If you want lower monthly costs and do not mind a network, Medicare Advantage may be the better choice.

Income-related costs: IRMAA explained

If your income is above a certain level, you pay extra on top of your regular Part B and Part D premiums. This extra amount is the Income-Related Monthly Adjustment Amount (IRMAA). Social Security calculates it based on your Modified Adjusted Gross Income (MAGI) from your tax return two years before the year you are paying for.

For 2024, if you file taxes as single and your MAGI is over $97,000, you start paying IRMAA. For married couples filing jointly, the threshold is $194,000. The higher your income, the more you pay — it can add $70 to $560 per month to your Part B premium alone.

You can request a review if your income dropped significantly — for example, due to retirement, death of a spouse, or loss of a job. Social Security may adjust your IRMAA based on your current year's income instead of the two-year-old tax return. You have to file a form called the Medicare Income-Related Monthly Adjustment Amount — Life-Changing Event (form SSA-44) to request this.

Costs you might not expect

Medicare does not cover everything. You pay the full cost for dental care, vision exams, hearing aids, and most long-term care. Some people buy Medigap (supplemental insurance) to cover costs that Original Medicare does not, such as copays and coinsurance. Medigap premiums range from roughly $100 to $400 per month depending on the plan and your age.

If you choose Medicare Advantage instead of Original Medicare, you do not need Medigap. However, you may pay more out of pocket for services outside the network or for services the plan does not cover.

You also pay for things like physical therapy copays, mental health visits, and preventive care. While Medicare covers many preventive services at no cost (like annual wellness visits and cancer screenings), other services have standard copays or coinsurance.

How to estimate your total monthly cost

To get a realistic picture of what you will pay, start with your premium costs: Part B (or Part C if you choose Medicare Advantage), Part D, and any IRMAA. Then add an estimate for out-of-pocket costs based on how often you see doctors and what medications you take.

Medicare.gov has a Plan Finder tool where you can enter your medications and doctors to see what different plans would cost you. This tool shows premiums, deductibles, and estimated out-of-pocket costs for each plan in your area. You can also call 1-800-MEDICARE to speak with someone who can walk you through the numbers.

Keep in mind that costs change every January. Review your coverage each year during the Annual Enrollment Period (October 15 to December 7) to see if a different plan would save you money. What was cheapest last year may not be cheapest this year.

Frequently Asked Questions

Do I have to pay Part B if I do not see a doctor?

Yes, you pay the monthly premium whether you use it or not. However, if you delay signing up for Part B when you first become may be able to access, you may face a permanent penalty that increases your premium for life. The only exception is if you have employer health insurance — you can delay Part B without penalty while you are still working.

What happens if I cannot afford my Medicare premiums?

You may be able to get help through Medicaid or the Medicare Savings Program, depending on your income and assets. Contact your state Medicaid office or call 1-800-MEDICARE to learn what programs might help you pay premiums and out-of-pocket costs.

Can I change my plan if my costs go up?

Yes, during the Annual Enrollment Period (October 15 to December 7) you can switch to a different Part D plan or Medicare Advantage plan. If you have a major life change like losing employer coverage, you may be able to change plans outside this window using a Special Enrollment Period.

Why is my Part B premium higher than my neighbor's?

Your income determines your premium through IRMAA. If your Modified Adjusted Gross Income is higher, you pay more. Social Security uses your tax return from two years ago, so your premium may not match your current income. You can request a review if your income has dropped significantly.

Does Medicare cover my prescriptions if I travel outside the United States?

Original Medicare Part D does not cover prescriptions filled outside the United States. Some Medicare Advantage plans offer limited coverage in certain countries. If you travel internationally, talk to your plan about coverage before you leave, or consider buying travel insurance that includes prescription coverage.