Most people turning 65 pay $185 per month for Medicare in 2025, and that’s the only premium many will owe. That $185 covers Part B (doctor visits and outpatient care), while Part A (hospital coverage) is free if you or your spouse paid Medicare taxes for at least 10 years of work. Your total cost depends on which parts of Medicare you sign up for, your income, and whether you add supplemental coverage.
Part A: Hospital Coverage
Part A covers hospital stays, skilled nursing facility care, and hospice. For most people, it costs $0 per month. You qualify for premium-free Part A if you (or your spouse) earned at least 40 work credits, which translates to roughly 10 years of employment where Medicare taxes were withheld from your paycheck.
If you don’t meet that threshold, you’ll pay a premium. People with 30 to 39 credits pay a reduced rate, while those with fewer than 30 credits pay the full premium, which can run several hundred dollars a month. Most people turning 65 have enough work history to qualify for $0, so this only affects a small number of enrollees.
Even with premium-free Part A, you’ll still face out-of-pocket costs if you’re hospitalized. The inpatient deductible for a hospital stay is over $1,600 per benefit period in 2025. After 60 days in the hospital, daily copays kick in as well.
Part B: Doctor Visits and Outpatient Care
Part B is the cost most people think of when they ask about Medicare premiums. The standard monthly premium is $185 in 2025, and it’s deducted directly from your Social Security check. On top of the monthly premium, Part B has an annual deductible of $257. After meeting that deductible, you typically pay 20% of the Medicare-approved amount for services like doctor visits, lab tests, and outpatient procedures.
That 20% coinsurance has no cap under Original Medicare, which is one reason many people buy supplemental insurance (more on that below).
Higher Premiums for Higher Earners
If your income is above a certain level, you’ll pay more for Part B and Part D through an income-related monthly adjustment amount, commonly called IRMAA. Medicare uses your tax return from two years prior to set these surcharges. So for 2025 premiums, Medicare looks at your 2023 income.
Here’s how Part B premiums scale with income in 2025:
- $106,000 or less (individual) / $212,000 or less (joint): $185 per month, no surcharge
- $106,001 to $133,000 (individual) / $212,001 to $266,000 (joint): $259 per month
- $133,001 to $167,000 (individual) / $266,001 to $334,000 (joint): $370 per month
- $167,001 to $200,000 (individual) / $334,001 to $400,000 (joint): $480.90 per month
- $200,001 to $499,999 (individual) / $400,001 to $749,999 (joint): $591.90 per month
- $500,000 or more (individual) / $750,000 or more (joint): $628.90 per month
Part D prescription drug coverage also carries income-based surcharges starting at the same thresholds, ranging from $13.70 to $85.80 per month on top of your plan’s premium. If your income has dropped significantly since the tax year Medicare is using (due to retirement, for example), you can appeal the surcharge by contacting Social Security.
Part D: Prescription Drug Coverage
Part D is optional but important. It covers prescription medications through private insurance plans, and premiums vary by plan and location. The national base beneficiary premium is $38.99 in 2026, but actual plan premiums range widely. Some plans charge under $10 a month, while others cost significantly more depending on the drugs they cover.
Plans can charge an annual deductible of up to $615 in 2026, though many plans have a lower deductible or none at all. After the deductible, you’ll pay copays or coinsurance for each prescription until you hit catastrophic coverage, at which point your costs drop sharply.
Medicare Advantage: An Alternative Path
Instead of Original Medicare (Parts A and B) plus a separate Part D plan, you can choose a Medicare Advantage plan (Part C). These are offered by private insurers and bundle hospital, outpatient, and usually drug coverage into one plan. Many Medicare Advantage plans charge $0 in additional premium beyond your standard Part B payment, and some include extras like dental, vision, and hearing coverage.
The trade-off is that Medicare Advantage plans use provider networks, so you’re generally limited to specific doctors and hospitals. They also have annual out-of-pocket maximums, which Original Medicare lacks. Whether this route saves you money depends on how much care you use and where you live.
Medigap: Filling the Gaps in Original Medicare
If you stick with Original Medicare, you may want a Medigap (Medicare Supplement) policy to cover costs like the 20% Part B coinsurance and hospital deductibles. These are sold by private insurers, and the premium depends on your age, location, and the plan you choose.
Plan G is the most popular Medigap option. In 2023, the average monthly premium for Plan G enrollees was $164, though it ranged from about $140 in states like Hawaii and New Mexico to $236 in New York. You get the best rates and guaranteed acceptance if you buy during your Medigap open enrollment period, which starts the month you turn 65 and are enrolled in Part B. After that six-month window, insurers can charge more or deny coverage based on your health.
What a Typical Month Actually Costs
For someone turning 65 with a standard income and 10 or more years of work history, a realistic monthly breakdown looks like this: $0 for Part A, $185 for Part B, and roughly $15 to $50 for a Part D drug plan. That puts your baseline at about $200 to $235 per month before any supplemental coverage. Add a Medigap plan and you’re looking at roughly $350 to $400 per month total. Choose Medicare Advantage instead of Medigap, and your monthly cost could stay closer to $185 to $220, though you’ll face copays and network restrictions when you use care.
Late Enrollment Penalties
Timing matters. If you don’t sign up for Part B when you’re first eligible and you don’t have qualifying coverage through an employer, you’ll pay a permanent penalty: 10% added to your Part B premium for every full 12-month period you delayed. That penalty never goes away. Someone who waited two years past their eligibility, for example, would pay 20% more on their Part B premium for life. In 2026 terms, that would mean roughly $243 per month instead of the standard $202.90.
Part D carries a similar penalty. If you go 63 or more consecutive days without creditable drug coverage after you’re first eligible, you’ll pay an extra 1% of the national base premium for every month you were uncovered. Twelve months without coverage adds about 12% to your Part D premium permanently.
Help With Medicare Costs
If your income and savings are limited, Medicare Savings Programs can cover some or all of your premiums, deductibles, and copays. In 2026, individuals earning up to $1,350 per month with resources below $9,950 may qualify for the most comprehensive help through the Qualified Medicare Beneficiary program, which pays your Part A and Part B premiums plus most cost-sharing. Programs for slightly higher incomes (up to $1,816 per month for individuals) cover the Part B premium alone. Income limits are somewhat higher in Alaska and Hawaii, and individual states sometimes extend eligibility beyond federal minimums.