Medicare has different monthly costs depending on which parts you choose and your income

Medicare Part A (hospital insurance) costs most people nothing per month 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 about $278 to $556 per month in 2024, depending on how many quarters of coverage you have.

Medicare Part B (medical insurance) costs $164.90 per month in 2024 for most people, but the amount changes each year. If your income is higher than a certain threshold — $97,000 for single filers, $194,000 for married couples filing jointly — you pay an additional surcharge called an Income-Related Monthly Adjustment Amount (IRMAA). That surcharge can add $70 to $560 per month on top of the base premium, depending on how much your income exceeds the threshold.

Medicare Part D (prescription drug coverage) costs vary widely by plan and by pharmacy. Monthly premiums typically range from $7 to $100 per month, but you also pay when you fill prescriptions — a copay or coinsurance amount that depends on which tier your drug falls into and whether you have hit your deductible.

Medicare Part C (Medicare Advantage) is an alternative to Parts A and B sold by private insurers. Some plans charge zero premium, while others charge $50 to $200 per month. You still pay the Part B premium separately to Medicare.

Key Takeaways

  • Part A is free for most people who worked and paid Medicare taxes; Part B costs $164.90 per month in 2024 and increases each year.
  • If your income exceeds $97,000 (single) or $194,000 (married), you pay an extra surcharge on top of the Part B premium.
  • Part D (prescription drug) premiums range from $7 to $100 per month depending on the plan you choose.
  • Part C (Medicare Advantage) premiums vary by plan and insurer, and some plans have no premium at all.
  • You can change your plan choices during the annual enrollment period (October 15 to December 7) each year.

How income affects what you pay for Part B and Part D

Medicare uses your Modified Adjusted Gross Income (MAGI) from your tax return from two years ago to determine whether you pay an IRMAA surcharge. If you earned more than $97,000 as a single filer or $194,000 as a married couple filing jointly in that year, you will pay extra. The surcharge brackets are tiered — the higher your income, the larger the surcharge.

If your income drops because you retire, lose a job, or have a major life change, you can request that Medicare recalculate your IRMAA using your current year's income instead. You must file a form called the Medicare Income-Related Monthly Adjustment Amount — Life-Changing Event (form SSA-44) with Social Security within 60 days of the event. Without this request, Medicare will use the older tax year's income.

Part D premiums are also income-tested. Plans in the lowest income bracket charge the least; plans in higher brackets charge more. The surcharge structure is the same as Part B — it kicks in at $97,000 (single) or $194,000 (married) and increases in tiers.

When you start Medicare and what you owe right away

Most people become may be able to access for Medicare at age 65. If you sign up during your initial enrollment period (the three months before, the month of, and the three months after your 65th birthday), your coverage typically starts on the first day of the month you turn 65. You will owe your first premium payment when coverage begins.

If you delay signing up for Part B after your initial enrollment period ends, you will pay a late enrollment penalty — an extra 10% of the Part B premium for each full 12 months you were may be able to access but did not enroll. That penalty stays with you for life, so delaying costs you permanently.

Part D has a similar late enrollment penalty: 1% of the national average Part D premium (about $1 in 2024) for each month you were may be able to access but did not enroll. Like Part B, this penalty is permanent.

What you pay out of pocket beyond the monthly premium

The monthly premium is only the beginning. Part A has a deductible of $1,632 per benefit period in 2024 — you pay this amount before Medicare covers hospital stays. Part B has a $240 annual deductible, after which Medicare typically covers 80% of approved services and you pay 20%.

Part D requires you to pay your deductible (which varies by plan, typically $505 to $550 in 2024) before the plan starts covering drugs. After you hit the deductible, you pay a copay or coinsurance for each prescription. Once you and your plan have spent $8,850 out of pocket in 2024, you enter the catastrophic phase and pay only a small copay for the rest of the year.

Medicare Advantage (Part C) plans have their own deductibles, copays, and out-of-pocket maximums. The out-of-pocket maximum is capped by law — in 2024, it cannot exceed $8,850 for in-network services. Once you hit that limit, the plan covers everything for the rest of the year.

How to estimate your total Medicare cost

Start with your monthly premiums: Part B ($164.90 in 2024) plus your Part D plan premium (check your plan's website for the exact amount). If you have Part C instead of Part A and B, use that plan's premium. Multiply by 12 to get your annual premium cost.

Then add the deductibles you are likely to hit: Part A deductible ($1,632 per hospital stay, if you are hospitalized), Part B deductible ($240 per year), and Part D deductible (varies by plan). Add your expected copays and coinsurance based on how often you see doctors and fill prescriptions.

If your income triggers an IRMAA surcharge, add that to your Part B and Part D premiums. You can find the exact surcharge amount on your Social Security statement or by calling Social Security at 1-800-772-1213.

Use the Medicare Plan Finder tool on Medicare.gov to compare specific plans in your area and see estimated costs side by side. You enter your prescriptions, doctors, and pharmacies, and the tool shows you which plans cost the least for your situation.

Changes to Medicare costs each year

Medicare premiums and deductibles change on January 1 each year. The Part B premium and deductible are announced in the fall, usually in October or November. Part D premiums and formularies (the list of covered drugs) also change yearly.

You have the right to change your plan during the annual enrollment period, which runs from October 15 to December 7 each year. Changes take effect on January 1. If you miss this window, you cannot switch plans unless you have a may have access to life event — such as moving, losing other insurance, or a major change in income.

Some people may have access to for Extra Help, a program that pays Part D premiums and reduces copays if your income is below 150% of the federal poverty level. Others may have access to for Medicaid (run by your state, not Medicare) if their income and assets are low enough. Medicaid can pay your Medicare premiums and cost-sharing on top of providing its own coverage.

Frequently Asked Questions

Do I have to pay for Medicare Part A if I never worked?

If you did not pay Medicare taxes for at least 10 years, you must pay a premium for Part A. The amount depends on how many quarters of coverage you have — it ranges from about $278 to $556 per month in 2024. Your spouse's work history can also count toward the 10-year requirement if you are married.

What happens if I cannot afford my Medicare premiums?

If your income is low, you may may have access to for Medicaid or Extra Help. Medicaid (run by your state) can pay your Medicare premiums and cost-sharing. Extra Help covers Part D premiums and reduces drug copays. Contact your state Medicaid office or call 1-800-MEDICARE to learn about programs in your area.

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

You can change plans during the annual enrollment period (October 15 to December 7). If you miss that window, you can only switch if you have a may have access to life event — such as moving, losing coverage, or a major income change. Contact Medicare to report the event within 60 days.

Do I pay the same Part B premium as everyone else?

Most people pay the standard Part B premium ($164.90 in 2024), but if your income is above $97,000 (single) or $194,000 (married), you pay an additional surcharge. The surcharge is based on your income from two years ago, so it can change when you retire or have other income changes.

What is the difference between what I pay now and what I will pay next year?

Medicare premiums and deductibles change every January 1. The Part B premium and deductible are announced in October. Part D premiums and drug formularies also change yearly. You can see the new amounts on Medicare.gov in the fall, and you have until December 7 to switch plans if the new costs do not work for you.