Medicare costs in 2025 depend on which parts you have and your income

Medicare has four parts, and each one costs differently. Part A (hospital insurance) is free for most people who paid Medicare taxes while working. Part B (doctor visits and outpatient care) costs a monthly premium that changes each year — for 2025, the standard premium is $185 per month, but you may pay more if your income is higher. Part D (prescription drugs) and Part C (Medicare Advantage, an alternative to Original Medicare) vary widely by plan and location.

Beyond premiums, you also pay deductibles, copays, and coinsurance when you use care. How much you actually spend depends on which parts you choose, which plan you pick, and how much medical care you need during the year.

Key Takeaways

  • Part A is free for most seniors; Part B costs $185 per month in 2025 for people with standard income, but higher earners pay more.
  • You also pay a deductible ($240 for Part A hospital stays, $350 for Part B outpatient care in 2025) before Medicare starts paying its share.
  • Part D (drug coverage) premiums and costs vary by plan; you choose a plan each year during open enrollment.
  • If your income is above certain thresholds, you pay an extra surcharge called IRMAA on top of your Part B and Part D premiums.
  • Original Medicare and Medicare Advantage have different cost structures; comparing them side by side for your situation can save hundreds of dollars.

Part A and Part B premiums and deductibles for 2025

Part A is free if you or your spouse paid Medicare taxes for at least 10 years while working. If you did not meet that requirement, you can buy Part A; the premium in 2025 is $278 per month if you have 30–39 quarters of coverage, or $505 per month if you have fewer than 30 quarters.

Part B costs $185 per month for 2025 if your income in 2023 was $97,000 or less (single) or $194,000 or less (married filing jointly). These income thresholds are called Modified Adjusted Gross Income, or MAGI. If your income was higher, you pay more — the surcharge can be as much as $560 per month for the highest earners.

When you use Part A, you pay a $1,600 deductible per hospital stay in 2025. For Part B, you pay a $350 deductible per year, then 20% coinsurance for most services after that. These numbers change every January.

How income affects what you pay (IRMAA)

If your income is above certain levels, Medicare charges you an extra amount called Income-Related Monthly Adjustment Amount, or IRMAA. This surcharge applies to Part B and Part D premiums. The income threshold that triggers IRMAA is $97,000 for single filers and $194,000 for married couples filing jointly in 2025, based on your income from two years prior (2023 tax return).

The surcharge increases in brackets. If your 2023 income was $97,001 to $121,500 (single), you pay an extra $74 per month on Part B. If it was $121,501 to $146,000, you pay an extra $185 per month. The highest earners pay up to $560 extra per month. Part D surcharges follow a similar structure.

If your income drops — for example, because you retired mid-year or had a major life change — you can ask Medicare to recalculate your IRMAA. You will need to file a form called an Income-Related Monthly Adjustment Amount Life-Changing Event appeal and provide proof of the change.

Part D prescription drug costs

Part D premiums vary by plan and location. In 2025, premiums range from roughly $7 to $100 per month depending on which plan you choose and where you live. When you fill a prescription, you also pay a copay or coinsurance — the amount depends on the drug's tier (how expensive it is) and your plan's design.

Part D has a coverage gap called the "donut hole." Once you and your plan have spent $5,850 on covered drugs in 2025, you enter the gap and pay a higher percentage of drug costs until your out-of-pocket spending reaches $8,550. After that, catastrophic coverage kicks in and you pay only a small copay for the rest of the year.

You choose a Part D plan during the Annual Enrollment Period, which runs October 15 to December 7 each year. Plans change their formularies (the drugs they cover) and costs every year, so comparing plans annually can save money even if you have been on the same plan for years.

Medicare Advantage (Part C) costs versus Original Medicare

Medicare Advantage is an alternative to Original Medicare. Instead of paying Part B premiums and deductibles to traditional Medicare, you enroll in a private plan that covers Part A, Part B, and usually Part D all together. Many Medicare Advantage plans charge $0 in premiums, but they have different cost structures: lower deductibles or copays for some services, but often higher out-of-pocket maximums.

In 2025, Medicare Advantage plans must cap your total out-of-pocket spending at $8,550 per year for in-network care. Original Medicare has no out-of-pocket cap, which means if you have a serious illness or injury, your costs can be much higher. However, Original Medicare gives you more freedom to see any doctor who accepts Medicare, while Medicare Advantage plans usually require you to use in-network providers.

The trade-off is real: a $0-premium Medicare Advantage plan might cost you less if you are healthy, but Original Medicare might cost less if you need frequent specialist visits or have a chronic condition that requires many different doctors. Comparing the two for your specific situation — your doctors, your medications, and your expected care — is worth doing every year.

Medigap (supplemental insurance) costs

Medigap is private insurance you buy to cover the gaps in Original Medicare — the deductibles, copays, and coinsurance that Medicare does not pay. Medigap premiums vary by plan letter (Plan A, Plan B, Plan C, etc.), your age, your location, and the insurance company. In 2025, premiums typically range from $100 to $300 per month, but some plans cost more in high-cost areas.

Medigap is only available if you have Original Medicare (Part A and Part B). You cannot use Medigap with Medicare Advantage. The best time to buy Medigap is within six months of turning 65 and enrolling in Part B, because insurance companies must accept you without waiting periods or exclusions for pre-existing conditions during this window. After that window closes, insurers can deny you or charge more based on your health history.

When and how to review your costs

Medicare costs change every January 1. Premiums, deductibles, and copays are announced in October, and you receive a notice called the Medicare & You Handbook in the mail in September or October. You can also find current costs on Medicare.gov.

The Annual Enrollment Period runs October 15 to December 7 each year. During this time, you can switch from Original Medicare to Medicare Advantage, from Medicare Advantage to Original Medicare, or change your Part D plan. If you miss this window, you cannot make changes until the next year unless you have a may have access to life event (such as losing employer coverage or moving to a new state).

If your income changes significantly — you retire, sell a home, or have a major life event — contact Social Security or Medicare to report it. A lower income may reduce or eliminate your IRMAA surcharge. You have 60 days from the date of the life event to request a recalculation.

Frequently Asked Questions

Do I have to pay for Part A?

Part A is free if you or your spouse paid Medicare taxes for at least 10 years while working. If you did not meet that requirement, you can buy Part A for $278 to $505 per month depending on how many years you paid taxes. Most people do not pay for Part A.

What happens if I do not sign up for Part B when I turn 65?

If you delay Part B without a valid reason, you pay a permanent 10% penalty on your Part B premium for each year you were may be able to access but did not enroll. For example, if you delay three years, you pay 30% extra for life. Sign up during your Initial Enrollment Period, which starts three months before the month you turn 65.

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) each year. If you have a may have access to life event — such as moving, losing coverage, or a major change in income — you may be able to change plans outside this window. Contact Medicare at 1-800-MEDICARE to ask about your situation.

Will my costs go down if I move to a different state?

Part B and Part D premiums are the same nationwide, but Medicare Advantage and Medigap plans vary by state and county. If you move, you will need to review plans available in your new location. You have 60 days from your move to enroll in a new plan without waiting for the Annual Enrollment Period.

What if I cannot afford my Medicare costs?

If your income is low, you may be able to get help through programs like the Medicare Savings Program or Low-Income Subsidy for Part D. These programs pay some or all of your premiums and cost-sharing. Contact your state Medicaid office or call 1-800-MEDICARE to learn whether you may have access to.