Most people pay $0 per month for Medicare Part A and $185 per month for Part B in 2025, bringing the baseline combined cost to $2,220 per year in premiums alone. But the actual amount you’ll pay depends on your work history, your income, and whether you signed up on time. Beyond premiums, both parts carry deductibles and coinsurance that add to your total out-of-pocket spending.
What Part A Costs Most People
Part A covers hospital stays, skilled nursing facility care, and hospice. If you or your spouse paid Medicare taxes for at least 10 years (40 quarters), you qualify for premium-free Part A. The vast majority of Medicare beneficiaries fall into this category and pay nothing monthly for Part A.
If you don’t have enough work history, you can still buy Part A, but the premiums are significant. In 2026, you’ll pay either $311 or $565 per month depending on how many years of Medicare taxes you have on record. The lower amount applies if you have 30 to 39 quarters of coverage. The higher amount applies if you have fewer than 30 quarters.
Part A also has costs when you actually use it. Each time you’re admitted to the hospital, a new “benefit period” begins, and you owe a deductible for that period. After 60 days in the hospital during a single benefit period, you start paying daily coinsurance that increases the longer you stay. For skilled nursing facility care, Medicare covers the first 20 days fully after a qualifying hospital stay, but days 21 through 100 cost you $217 per day in 2026. After day 100, Medicare stops covering skilled nursing entirely.
What Part B Costs at Standard Income
Part B covers doctor visits, outpatient care, preventive services, medical equipment, and mental health treatment. The standard monthly premium for 2025 is $185. This amount is typically deducted directly from your Social Security check.
On top of the premium, Part B has an annual deductible. Once you meet it, you generally pay 20% of the Medicare-approved amount for most services. That 20% coinsurance applies to things like specialist visits, diagnostic tests, outpatient surgeries, and mental health treatment. Some preventive services, including depression screenings and alcohol misuse screenings, are covered at no cost to you.
If you receive outpatient care at a hospital rather than a freestanding clinic, you may owe an additional facility copayment on top of the standard 20% coinsurance. This is worth keeping in mind when choosing where to get care.
How Higher Income Raises Your Part B Premium
Medicare uses your tax return from two years prior to determine whether you owe more than the standard Part B premium. This surcharge is called the Income-Related Monthly Adjustment Amount, or IRMAA. For 2025, the income brackets and total monthly premiums break down like this for individual filers:
- $106,000 or less: $185 per month (standard)
- $106,001 to $133,000: $259 per month
- $133,001 to $167,000: $370 per month
- $167,001 to $200,000: $480.90 per month
- $200,001 to $499,999: $591.90 per month
- $500,000 or more: $628.90 per month
For married couples filing jointly, the thresholds are roughly double. You’ll pay the standard $185 if your combined modified adjusted gross income is $212,000 or less. The surcharges kick in above that, topping out at $628.90 per month each for couples earning $750,000 or more.
If you’re married but file separately and lived with your spouse at any point during the year, the brackets are much less forgiving. Income above $106,000 jumps you straight to $591.90 per month, with the highest tier starting at $394,000.
These same income brackets also trigger surcharges on Part D prescription drug coverage, so higher earners pay more across multiple parts of Medicare simultaneously.
Combined Annual Costs: A Quick Snapshot
For someone with premium-free Part A and the standard Part B premium, the baseline annual cost in 2025 is $2,220 in premiums plus the Part B deductible, before any coinsurance kicks in. At the highest IRMAA tier, Part B premiums alone reach $7,546.80 per year. Add in the 20% coinsurance on outpatient services and any hospital deductibles, and annual spending can climb considerably, which is why many people purchase supplemental Medigap policies or choose Medicare Advantage plans to limit exposure.
Late Enrollment Penalties
Signing up late for either Part A or Part B adds a permanent surcharge to your premiums. For Part A (if you’re someone who has to pay a premium), enrolling late increases your monthly cost by 10%, and you’ll pay that penalty for twice the number of years you delayed. So if you waited three years, you’d pay the higher premium for six years.
Part B penalties are steeper and last longer. Your premium goes up 10% for every full 12-month period you were eligible but didn’t enroll. If you delayed two years, that’s a 20% increase. Three years, 30%. The critical difference: Part B late enrollment penalties typically last for as long as you have Part B coverage, which for most people means the rest of your life. A two-year delay in signing up could mean paying roughly $444 extra per year, every year, on top of whatever the standard premium happens to be.
These penalties don’t apply if you had qualifying coverage through an employer or a Special Enrollment Period that excused the gap. But if you simply didn’t sign up because you didn’t think you needed it, the math works against you quickly.
What Part B Covers for Mental Health
Mental health services fall under Part B, and the cost-sharing follows the same general structure. After meeting the annual deductible, you pay 20% of the Medicare-approved amount for visits to diagnose or treat mental health conditions, as long as your provider accepts Medicare’s payment terms. Depression and alcohol misuse screenings are fully covered with no out-of-pocket cost.
For more intensive treatment like partial hospitalization or intensive outpatient programs, you pay coinsurance for each day of services at a hospital outpatient setting or community mental health center. Opioid use disorder treatment through a Medicare-enrolled program carries no copayments, though the Part B deductible still applies to supplies and medications.