Medicare Costs and Premiums: What You May Pay

Part A premiums and cost sharing

Most people qualify for premium-free Part A based on their own or a spouse's work history. People who do not qualify may be able to buy Part A by paying a monthly premium.

Even with a premium-free Part A, you can owe a deductible for each benefit period and coinsurance for long hospital or skilled nursing facility stays.

Part B premiums and cost sharing

Part B has a standard monthly premium, an annual deductible, and coinsurance that is typically a percentage of the Medicare-approved amount for most services.

The premium is commonly deducted from a Social Security benefit, and it can be higher for people with higher reported income.

Part D costs

Part D costs include the plan premium, a possible deductible, and cost sharing that depends on the drug's tier and the pharmacy you use. There is also an annual limit on what enrollees pay out of pocket for covered Part D drugs.

A late enrollment penalty may be added to the premium for people who went without creditable drug coverage.

Medicare Advantage costs

With a Medicare Advantage plan you generally continue paying your Part B premium, plus any plan premium, plus copayments or coinsurance when you receive care. Plans include an annual maximum out-of-pocket limit for covered Part A and Part B services.

Medicare Supplement premiums

Medigap policies charge a monthly premium in addition to your Part B premium. Premiums vary by plan letter, insurance company, state, age, tobacco use, and the rating method the company uses, and they generally change over time.

IRMAA

The income-related monthly adjustment amount, or IRMAA, is an additional charge added to Part B and Part D premiums for beneficiaries whose reported income exceeds set thresholds. It is determined by the Social Security Administration using tax return data from a prior year.

If your income has dropped because of a qualifying life-changing event, you can ask Social Security to reconsider the determination.

No annual out-of-pocket maximum under Original Medicare alone

Original Medicare by itself does not cap what you may pay out of pocket in a year. That is a structural difference from Medicare Advantage plans, which include an annual limit for covered medical services, and it is why many people add a Medigap policy.

Assistance programs

Medicare Savings Programs and Extra Help may reduce premiums or cost sharing for people who meet income and resource requirements. Eligibility is determined by government agencies.

Why this page does not list dollar amounts

Medicare premiums, deductibles, and limits are set for each plan year and change regularly. Rather than publish figures we have not verified for the current plan year, we describe how each cost works and point you to authoritative sources for the exact amounts.

For current figures, visit Medicare.gov or call 1-800-MEDICARE (TTY 1-877-486-2048), 24 hours a day, 7 days a week, or review the plan's own documents.

Important disclosures

• Plan availability, benefits, provider networks, formularies, and costs vary by carrier and by location, and can change each plan year.
• Deductibles, copayments, coinsurance, limitations, and exclusions may apply.
• Insurance Allies is a private, non-government entity. It is not connected with or endorsed by the United States government, the federal Medicare program, or the Centers for Medicare & Medicaid Services (CMS).
• The information on this page is general and educational. It is not legal, tax, medical, or financial advice.