For most people, Original Medicare costs $185 per month in 2025. That’s the standard Part B premium, and it’s often the only regular bill you’ll see, since Part A (hospital insurance) is free if you or your spouse paid Medicare taxes for at least 10 years. Beyond that monthly premium, you’ll also face deductibles and coinsurance when you actually use care. Here’s how all the costs break down.
Part A: Hospital Insurance
Part A covers inpatient hospital stays, skilled nursing facility care, hospice, and some home health services. Most people pay $0 in monthly premiums because they (or a spouse) worked and paid Medicare taxes for 10 or more years, which equals 40 work quarters.
If you don’t have enough work history, you can still buy into Part A. The 2025 premium is either $311 or $565 per month, depending on how many years of Medicare taxes you have on record. People with 30 to 39 quarters of coverage pay the lower amount, while those with fewer than 30 quarters pay the full $565.
Even with premium-free Part A, you pay out of pocket when you’re admitted to the hospital. Each benefit period starts with a deductible (which resets if you haven’t been an inpatient for 60 consecutive days). After that deductible, the first 60 days of a hospital stay are fully covered. Days 61 through 90 come with a daily coinsurance charge, and if you need to tap into your 60 lifetime reserve days, the daily cost is higher still. A short hospital stay may only cost you the deductible, but a long one can add up fast.
Part B: Medical Insurance
Part B covers doctor visits, outpatient procedures, lab tests, preventive screenings, durable medical equipment, and mental health care. The standard monthly premium for 2025 is $185, deducted automatically from your Social Security check.
On top of the premium, Part B has an annual deductible. Once you meet it, you typically pay 20% of the Medicare-approved amount for most services. That 20% coinsurance applies to everything from specialist visits to outpatient surgery, and there is no annual out-of-pocket cap on Original Medicare. This is one of the main reasons many people add a Medigap (supplement) plan or choose Medicare Advantage instead.
Preventive services like annual wellness visits, flu shots, and depression screenings are covered at no cost to you, as long as your provider accepts Medicare assignment.
Mental Health Services
Outpatient mental health visits follow the same 20% coinsurance rule after you meet your Part B deductible. If you receive care at a hospital outpatient department rather than a private office, you may owe an additional facility copayment on top of that 20%.
Higher Premiums for Higher Earners
If your income is above a certain threshold, you’ll pay more for Part B through a surcharge called IRMAA (Income-Related Monthly Adjustment Amount). The income used is your modified adjusted gross income from two years prior, so your 2023 tax return determines your 2025 premiums.
For 2025, the income brackets and total monthly Part B premiums look like this:
- $106,000 or less (single) / $212,000 or less (married filing jointly): $185.00
- $106,001 to $133,000 (single) / $212,001 to $266,000 (joint): $259.00
- $133,001 to $167,000 (single) / $266,001 to $334,000 (joint): $370.00
- $167,001 to $200,000 (single) / $334,001 to $400,000 (joint): $480.90
- $200,001 to $499,999 (single) / $400,001 to $749,999 (joint): $591.90
- $500,000 or more (single) / $750,000 or more (joint): $628.90
At the highest income tier, you’d pay nearly $7,550 per year just for Part B. If your income has dropped significantly since your last tax return (due to retirement, divorce, or the death of a spouse), you can request that Social Security use more recent income to recalculate your premium.
Late Enrollment Penalties
Signing up late for Medicare can permanently raise your premiums. For Part B, the penalty is an extra 10% added to your standard premium for every full 12-month period you were eligible but didn’t enroll. This penalty stays on your premium for as long as you have Part B. If you delayed enrollment by two years without qualifying for a special enrollment period, for example, you’d pay 20% more than the standard premium every month going forward.
Part A has a similar penalty if you have to pay a premium (meaning you didn’t earn enough work credits for free coverage). The surcharge applies for twice as long as you delayed. These penalties are easy to avoid if you sign up during your initial enrollment period or have qualifying employer coverage, but they can be costly if you miss the window.
What Original Medicare Doesn’t Cap
One of the biggest cost risks with Original Medicare is the lack of an annual out-of-pocket maximum. Private insurance plans and Medicare Advantage plans cap what you spend each year, but Original Medicare does not. If you have a major health event, that 20% coinsurance on Part B services and the daily hospital coinsurance under Part A can climb without limit.
This is why many beneficiaries pair Original Medicare with a Medigap supplemental policy. Medigap plans charge their own monthly premium (which varies by plan type, your age, and where you live) but cover some or all of the cost-sharing gaps. Without supplemental coverage, a single hospitalization or a series of specialist visits could result in thousands of dollars in unexpected bills.
Help Paying Medicare Costs
If your income and savings are limited, Medicare Savings Programs can cover some or all of your Medicare costs. There are three main tiers:
- Qualified Medicare Beneficiary (QMB): Covers Part A and Part B premiums, deductibles, and coinsurance. Available to individuals earning up to $1,350 per month with resources below $9,950.
- Specified Low-Income Medicare Beneficiary (SLMB): Pays your Part B premium. Individual income limit is $1,616 per month.
- Qualifying Individual (QI): Also pays your Part B premium, with an individual income limit of $1,816 per month.
For married couples, the income and resource limits are higher. Limits are also slightly higher in Alaska and Hawaii. You apply through your state Medicaid office, and eligibility is reassessed annually.
Putting the Total Cost Together
For a typical beneficiary with free Part A and the standard Part B premium, the baseline annual cost of Original Medicare in 2025 is $2,220 in premiums alone ($185 times 12 months). On top of that, you’ll owe the Part B annual deductible, 20% coinsurance on most outpatient services, and the Part A hospital deductible each time you’re admitted. A healthy year with just a few doctor visits might cost you under $3,000 total. A year with surgery or a hospital stay could cost significantly more, since there’s no spending cap to protect you.
Original Medicare also does not cover dental care, vision exams, hearing aids, or most long-term custodial care. Those gaps represent additional out-of-pocket expenses that many people don’t anticipate when budgeting for retirement health costs.