Most people on Medicare Advantage (Part C) pay nothing beyond their standard Part B premium, and stand-alone Part D drug plans average around $38 per month. But your actual costs depend on the specific plan you choose, your income, and how much care you use. Here’s a full breakdown of what to expect in 2025.
Medicare Part C (Advantage) Premiums
Medicare Advantage plans are sold by private insurers as an alternative to Original Medicare. They bundle Part A (hospital) and Part B (medical) coverage into one plan, and most also include prescription drug coverage. In 2025, 76% of Medicare Advantage enrollees pay no additional premium beyond the standard Part B premium of $185 per month. When you average across all enrollees, including those who do pay a plan premium, the typical cost comes out to about $13 per month on top of Part B.
That $13 figure can be misleading, though. It’s an average pulled down by the large number of $0-premium plans. If you pick a plan with richer benefits, broader provider networks, or extra perks like dental and vision, your monthly premium could be $50, $100, or more. Every plan sets its own rates, and those rates change each year.
Out-of-Pocket Costs for Part C
Premiums are only one piece of the cost picture. Medicare Advantage plans charge copayments for office visits (commonly around $30 for primary care, more for specialists), coinsurance for procedures, and sometimes a yearly deductible before coverage kicks in. Each plan designs its own cost-sharing structure, so two plans in the same zip code can have very different copays for the same visit.
The critical number to look at is the plan’s maximum out-of-pocket limit for in-network services. This is the most you’d spend on covered care in a calendar year before the plan pays 100%. CMS sets a ceiling on how high plans can set this limit, but most plans choose a number well below that ceiling. When comparing plans, this cap is one of the best ways to gauge your financial risk if you have a major health event.
Medicare Part D Premiums
Part D covers prescription drugs. You can get it as a stand-alone plan paired with Original Medicare, or it may be built into your Medicare Advantage plan. For stand-alone Part D plans in 2025, the average total premium is about $38 per month. Actual premiums range widely depending on the plan’s formulary (the list of drugs it covers) and how generous its cost-sharing is. Plans covering a broader range of brand-name medications generally cost more.
If your Part D coverage comes through a Medicare Advantage plan instead, the drug premium is typically folded into that plan’s overall premium, which is why so many Advantage enrollees appear to pay $0 for drug coverage separately.
Part D Deductibles and the $2,000 Cap
The maximum annual deductible for Part D plans in 2025 is $590. Many plans set their deductible lower, and some waive it entirely, especially for generic drugs. Until you meet the deductible, you pay the full cost of your prescriptions.
The biggest change to Part D in recent years is the new $2,000 annual out-of-pocket cap, created by the Inflation Reduction Act. Once your total out-of-pocket drug spending hits $2,000 in a calendar year, you pay nothing more for covered prescriptions for the rest of that year. Before this cap took effect, people taking expensive medications could face thousands of dollars in costs with no ceiling. Plans also let you spread that $2,000 across monthly installments rather than absorbing it all at once early in the year.
Insulin has its own cost protection: you pay no more than $35 for a one-month supply of each covered insulin product, with no deductible. A three-month supply costs no more than $105. This applies to all Part D enrollees, including those receiving Extra Help.
Income-Related Surcharges (IRMAA)
If your income is above certain thresholds, you’ll pay a monthly surcharge on top of your Part D premium. Medicare calls this the Income-Related Monthly Adjustment Amount, or IRMAA. It’s based on your modified adjusted gross income from two years prior (so your 2023 tax return determines your 2025 surcharge).
For individuals earning $106,000 or less (or couples filing jointly earning $212,000 or less), there’s no surcharge. Above those levels, the Part D surcharge rises in tiers:
- $106,001 to $133,000 (individual) / $212,001 to $266,000 (joint): $13.70 per month
- $133,001 to $167,000 / $266,001 to $334,000: $35.30 per month
- $167,001 to $200,000 / $334,001 to $400,000: $57.00 per month
- $200,001 to $499,999 / $400,001 to $749,999: $78.60 per month
- $500,000 or more / $750,000 or more: $85.80 per month
These surcharges also apply to Part B premiums at even steeper amounts. At the highest income tier, your total Part B premium alone reaches $628.90 per month. If your income has dropped significantly since the tax year Medicare is using (due to retirement, divorce, or other life changes), you can appeal the surcharge by filing a form with Social Security.
Late Enrollment Penalties
If you don’t sign up for Part D when you’re first eligible and go 63 or more consecutive days without creditable drug coverage (coverage at least as good as Part D), you’ll face a permanent penalty added to your monthly premium. The penalty is 1% of the national base beneficiary premium for every month you went without coverage. In 2026, that base premium is $38.99, so someone who delayed 14 months would pay an extra $5.50 per month for as long as they have Part D.
Part B has a similar but steeper penalty: 10% added to your premium for each full year you delayed enrollment. These penalties don’t expire, so they compound over time and make coverage permanently more expensive.
Financial Help for Lower Incomes
Medicare’s Extra Help program (also called the Low-Income Subsidy) significantly reduces Part D costs for people with limited income and savings. In 2025, you may qualify if your individual income is below $23,475 and your resources (savings, investments, real estate other than your home) are below $17,600. For married couples, the limits are $31,725 in income and $35,130 in resources. Alaska and Hawaii have higher thresholds.
Extra Help can cover most or all of your Part D premium, deductible, and copayments. Even if your income is slightly above the listed limits, you may still qualify if you support family members living with you. You apply through Social Security, and there’s no penalty for applying and being denied.
What’s Changing in 2026
CMS projects that average premiums will drop modestly next year. The average Medicare Advantage premium is estimated to fall from $16.40 to $14.00 per month, and the average stand-alone Part D premium is projected to decrease from $38.31 to $34.50. For people with drug coverage through a Medicare Advantage plan, the average Part D component is expected to drop from $13.32 to $11.50. These are averages, and individual plan prices will vary, but the overall trend for 2026 points to stable or slightly lower costs.