Most Medicare Advantage plans charge $0 in monthly premiums beyond the standard Part B premium you’re already required to pay. That Part B premium is the true baseline cost, and for 2026 it starts at $185.00 per month for most beneficiaries (though this can rise significantly based on income). Your total monthly spending on a Medicare Advantage plan depends on the plan premium itself, the Part B premium, any prescription drug surcharges, and the copayments you rack up when you actually use care.
The Part B Premium You Pay No Matter What
Every Medicare Advantage enrollee must continue paying the standard Medicare Part B premium. This is non-negotiable, regardless of which Advantage plan you pick. For 2026, the standard amount is $185.00 per month, deducted directly from your Social Security check. Many people overlook this when comparing Advantage plan costs because it doesn’t appear on the plan’s marketing materials, but it’s the single largest fixed monthly expense for most enrollees.
If your income is higher, you’ll pay more. Medicare uses your tax return from two years prior to calculate an income-related monthly adjustment amount (IRMAA) that gets added on top of the standard premium. For a single filer in 2026, the thresholds and total Part B premiums break down like this:
- $109,000 or less: $185.00 (standard premium)
- $109,001 to $137,000: $284.10
- $137,001 to $171,000: $405.80
- $171,001 to $205,000: $527.50
- $205,001 to $499,999: $649.20
- $500,000 or more: $689.90
For married couples filing jointly, double those income thresholds. If you earned $274,000 or less jointly, you pay the standard $185.00. Above that, the same surcharge tiers apply at roughly twice the single-filer income levels.
The Plan Premium Itself
On top of the Part B premium, each Medicare Advantage plan can charge its own monthly premium. A large share of plans set this at $0, which is one of the main reasons Advantage plans appeal to people on a fixed budget. Plans can afford to do this because Medicare pays insurers a per-member payment based on local benchmarks. When a plan’s costs come in below that benchmark, the insurer keeps a portion of the difference as “rebate dollars” and uses the rest to lower premiums or add benefits.
Plans that do charge a premium typically range from $10 to $100 or more per month, depending on the plan type and region. HMO plans tend to be cheaper than PPO plans because they restrict you to a narrower network of doctors and hospitals. Plans with richer benefits, lower copays, or broader networks generally charge higher premiums. So a $0-premium plan isn’t automatically the cheapest option once you factor in what you’ll pay each time you visit a doctor or fill a prescription.
Prescription Drug Coverage Costs
Most Medicare Advantage plans bundle prescription drug coverage (Part D) into the plan at no extra premium. If yours does, there are still costs to know about. The standard Part D deductible for 2025 is $590 per year, meaning you pay full price for prescriptions until you hit that amount. Not all plans charge the full deductible, and some waive it entirely for generic drugs.
After the deductible, you typically pay 25% of your drug costs during what’s called the initial coverage phase. A major change took effect in 2025: the old “donut hole” coverage gap was eliminated entirely, and a hard cap of $2,000 per year now limits your total out-of-pocket drug spending. Once you hit $2,000, you pay nothing for covered prescriptions for the rest of the year. This is a significant shift that makes monthly drug costs more predictable than they were even a couple of years ago.
Higher-income earners face an IRMAA surcharge on drug coverage too. For a single filer earning between $109,001 and $137,000, that adds $14.50 per month on top of whatever the plan charges. At incomes above $500,000, the surcharge reaches $91.00 per month.
Copays, Coinsurance, and Deductibles
Your monthly premium is only part of the picture. Medicare Advantage plans charge you each time you use services, and these costs vary widely from plan to plan. Common cost-sharing structures include a flat copay for primary care visits (often $0 to $20), a higher copay for specialists ($20 to $50 is typical), and a daily or per-admission charge for hospital stays. Some plans use coinsurance instead, where you pay a percentage of the total bill rather than a flat fee.
Plans also set annual deductibles for medical services, though many Advantage plans set this at $0 for in-network care. The variation here is enormous. Two plans in the same zip code can look identical on premium but differ by hundreds of dollars in what you’d actually spend during a hospitalization or a series of specialist visits. The best way to compare is to look at total estimated yearly costs for your specific medications and expected doctor visits, which the Medicare Plan Finder tool calculates for you.
Out-of-Pocket Maximums
One advantage Medicare Advantage has over Original Medicare is a mandatory annual cap on your spending. Original Medicare has no out-of-pocket maximum, meaning costs can theoretically spiral without limit. Advantage plans must cap your in-network spending at no more than $9,350 per year (2025 figure). For plans that cover out-of-network care, the combined cap can’t exceed $14,000.
Many plans set their caps well below these maximums to attract enrollees. Once you hit your plan’s limit, the plan covers 100% of your covered services for the rest of the year. This ceiling is one of the strongest financial protections Medicare Advantage offers, especially if you face a serious illness or unexpected surgery.
Dental, Vision, and Hearing Benefits
Most Medicare Advantage plans include some level of dental, vision, and hearing coverage at no extra premium. These benefits aren’t available under Original Medicare, which is another reason people choose Advantage plans. Insurers fund these extras using rebate dollars from Medicare. In recent years, roughly $29 per enrollee per month in rebate funds went toward supplemental benefits not covered by traditional Medicare.
The depth of coverage varies significantly. Some plans cover only preventive dental care like cleanings and X-rays, while others include restorative work like crowns or dentures. About 10% of Medicare Advantage enrollees pay a separate premium to access dental benefits, usually because they’ve chosen a plan with more comprehensive dental coverage. Vision benefits commonly include an annual eye exam and an allowance toward glasses or contacts. Hearing benefits may cover annual screenings and a discount or allowance toward hearing aids.
A Realistic Monthly Budget
For a typical enrollee with income under $109,000 (single) or $218,000 (married filing jointly), the fixed monthly cost breaks down simply. You’ll pay $185.00 for Part B plus whatever your plan charges, which is often $0. That puts many people’s guaranteed monthly cost at $185.00 total. On top of that, you’ll pay copays and coinsurance when you use services, and prescription costs up to the $2,000 annual cap.
If you’re a relatively healthy person who sees a primary care doctor a few times a year and takes one or two generic medications, your effective monthly cost might land in the $200 to $250 range. Someone managing multiple chronic conditions, seeing specialists regularly, and taking several brand-name drugs could spend $400 to $600 per month on average when you spread annual costs across twelve months. The out-of-pocket cap ensures that even in a worst-case year, your total spending on medical services stays bounded.