Most people on Medicare pay $185 per month for Part B in 2025, and that’s the only premium many enrollees owe. But your total monthly cost depends on which parts of Medicare you have, your income, and whether you add prescription drug or supplemental coverage. A typical enrollee paying for Part B plus a standalone drug plan spends roughly $224 per month before any additional coverage.
Part A: Hospital Coverage
Part A covers hospital stays, skilled nursing facilities, and hospice care. Most people pay $0 for Part A because they or a spouse paid Medicare taxes for at least 10 years (40 work quarters). If you don’t meet that threshold, you’ll pay either $311 or $565 per month depending on how long you or your spouse worked and paid into the system. The lower amount applies if you have 30 to 39 quarters of coverage.
Part B: The $185 Standard Premium
Part B covers doctor visits, outpatient care, preventive services, and medical equipment. The standard monthly premium is $185 in 2025, and it’s typically deducted automatically from your Social Security check. On top of that, you’ll pay a $257 annual deductible before Part B starts covering its share of costs. After the deductible, you’re generally responsible for 20% of covered services.
Higher Premiums for Higher Earners
If your income exceeds certain thresholds, you’ll pay more for both Part B and prescription drug coverage through a surcharge called IRMAA (income-related monthly adjustment amount). Medicare uses your tax return from two years prior to set these amounts. For 2026 premiums, for example, they’ll look at your 2024 income.
For single filers, the surcharges kick in above $109,000 in modified adjusted gross income. For married couples filing jointly, the threshold is $218,000. Here’s what Part B costs at each income tier for single filers:
- $109,001 to $137,000: $284.10 per month
- $137,001 to $171,000: $405.80 per month
- $171,001 to $205,000: $527.50 per month
- $205,001 to $499,999: $649.20 per month
- $500,000 or more: $689.90 per month
Married couples filing jointly hit these same premium amounts at roughly double the income thresholds ($218,001 to $274,000 for the first tier, up to $750,000 or more for the highest). If you’re married filing separately, the brackets are much narrower: you jump to $649.20 per month once your income exceeds $109,000.
Higher earners also pay a surcharge on prescription drug coverage, ranging from $14.50 to $91 per month on top of whatever their drug plan charges.
Part D: Prescription Drug Coverage
Standalone Part D drug plans average $39 per month in 2025, down about 9% from the previous year. Premiums vary widely by plan and location, though, ranging from under $10 to well over $100 per month. Starting in 2025, Part D also caps total out-of-pocket drug spending at $2,000 per year, a significant change from prior years when catastrophic costs could climb much higher.
If you don’t sign up for drug coverage when you’re first eligible and go 63 or more days without comparable coverage, you’ll face a permanent penalty: an extra 1% of the national base premium for every month you delayed. That adds up to 12% per year of delay, and it stays on your premium for as long as you have Part D.
Medicare Advantage: An Alternative Package
Medicare Advantage plans (Part C) bundle Part A, Part B, and usually Part D into a single plan run by a private insurer. About 76% of Medicare Advantage enrollees pay no additional premium beyond their standard $185 Part B premium. Across all enrollees, the average additional premium works out to just $13 per month.
These plans often include benefits Original Medicare doesn’t cover, like dental, vision, and hearing. The tradeoff is that you’re typically limited to a network of providers and may need referrals to see specialists. Out-of-pocket maximums vary by plan but provide a spending cap that Original Medicare lacks.
Medigap: Supplemental Coverage Costs
If you stick with Original Medicare (Parts A and B), you might want a Medigap policy to cover costs like the 20% coinsurance on Part B services, which has no annual cap. Medigap premiums vary significantly by insurer, plan letter, your age, and where you live. Two companies selling the identical Plan G in the same city can charge very different amounts, so comparing quotes is essential.
Premiums typically range from about $75 to over $300 per month depending on these factors. Some insurers offer discounts for non-smokers, women, married couples, or automatic payment. Your best window to buy is during your six-month Medigap open enrollment period, which starts the month you turn 65 and are enrolled in Part B. During that window, insurers can’t charge you more or deny you coverage based on health conditions.
What a Typical Month Actually Costs
Here’s what monthly costs look like for a few common scenarios, assuming standard income levels:
- Original Medicare only (Parts A and B): $185 per month. You’d pay 20% coinsurance on Part B services with no out-of-pocket cap.
- Original Medicare plus Part D: roughly $224 per month ($185 plus an average $39 drug plan).
- Original Medicare, Part D, and Medigap: $300 to $500+ per month depending on your Medigap plan and location, but with significantly lower out-of-pocket risk.
- Medicare Advantage: $185 per month for most enrollees (just the Part B premium), with drug coverage and extra benefits often included.
Late Enrollment Penalties
Signing up late for Medicare can permanently increase your premiums. For Part B, you’ll pay an extra 10% for every full 12-month period you could have been enrolled but weren’t. If you delayed three years, that’s a 30% surcharge on your Part B premium for life. The Part A penalty, for those who must buy Part A, is a 10% premium increase that lasts twice as long as the period you delayed.
These penalties don’t apply if you had qualifying coverage through an employer during the gap. But if you were simply uninsured or had non-qualifying coverage, the surcharges are permanent.
Help Paying for Medicare
If your income is limited, Medicare Savings Programs can cover some or all of your Medicare costs. The Qualified Medicare Beneficiary (QMB) program pays your Part B premium, deductibles, and coinsurance. To qualify as an individual, your monthly income must be below $1,350 with resources under $9,950. For married couples, the limits are $1,824 in monthly income and $14,910 in resources.
Two other programs help with premiums specifically. The Specified Low-Income Medicare Beneficiary (SLMB) program covers Part B premiums for individuals earning up to $1,616 per month. The Qualifying Individual (QI) program extends that to $1,816 per month. Both have the same resource limits as QMB. Income limits are slightly higher in Alaska and Hawaii, and some states set their own thresholds above the federal minimums. You apply through your state Medicaid office.