Medicare Costs

The Medicare Costs for Medicare Part B and Part D, as well as supplemental coverage, are something that many don’t anticipate. It can surprise you when you turn 65 and learn that Medicare is not free.

How much does Part A cost?

Premium-free Part A

You usually don’t pay a monthly premium for Medicare Part A (Hospital Insurance) coverage if you or your spouse paid Medicare taxes for a certain amount of time while working. This is sometimes called “premium-free Part A.”

Most people get premium-free Part A.

You can get premium-free Part A at 65 if:

  • You already get retirement benefits from Social Security or the Railroad Retirement Board.
  • You’re eligible to get Social Security or Railroad benefits but haven’t filed for them yet.
  • You or your spouse had Medicare-covered government employment.

If you’re under 65, you can get premium-free Part A if:

  • You got Social Security or Railroad Retirement Board disability benefits for 24 months.
  • You have End-Stage Renal Disease (ESRD) and meet certain requirements.

Part A premiums

If you don’t qualify for premium-free Part A, you can buy Part A.

People who buy Part A will pay a premium of either $259 or $471 each month in 2021 depending on how long they or their spouse worked and paid Medicare taxes. If you choose NOT to buy Part A, you can still buy Part B.

In most cases, if you choose to buy Part A, you must also:

  • Have Medicare Part B (Medical Insurance)
  • Pay monthly premiums for both Part A and Part B

Contact Social Security for more information about the Part A premium.

How much does Part B cost?

Part B premiums

You pay a premium each month for Part B. Your Part B premium will be automatically deducted from your benefit payment if you get benefits from one of these:

  • Social Security
  • Railroad Retirement Board
  • Office of Personnel Management

If you don’t get these benefit payments, you’ll get a bill. 

Most people will pay the standard premium amount. If your modified adjusted gross income is above a certain amount, you may pay an Income Related Monthly Adjustment Amount (IRMAA). Medicare uses the modified adjusted gross income reported on your IRS tax return from 2 years ago. This is the most recent tax return information provided to Social Security by the IRS. 

2021

The standard Part B premium amount in 2021 is $148.50. Most people pay the standard Part B premium amount. If your modified adjusted gross income as reported on your IRS tax return from 2 years ago is above a certain amount, you’ll pay the standard premium amount and an Income Related Monthly Adjustment Amount (IRMAA). IRMAA is an extra charge added to your premium.

If your yearly income in 2019 (for what you pay in 2021) wasYou pay each month (in 2021)
File individual tax returnFile joint tax returnFile married & separate tax return
$88,000 or less$176,000 or less$88,000 or less$148.50
above $88,000 up to $111,000above $176,000 up to $222,000Not applicable$207.90
above $111,000 up to $138,000above $222,000 up to $276,000Not applicable$297.00
above $138,000 up to $165,000above $276,000 up to $330,000Not applicable$386.10
above $165,000 and less than $500,000above $330,000 and less than $750,000above $88,000 and less than $412,000$475.20
$500,000 or above$750,000 and above$412,000 and above$504.90

Part B deductible & coinsurance

In 2021, you pay $203 for your Part B deductible. After you meet your deductible for the year, you typically pay 20% of the Medicare-approved amount for these:

  • Most doctor services (including most doctor services while you’re a hospital inpatient)
  • Outpatient therapy
  • Durable Medical Equipment (DME)

Medicare costs at a glance

Listed below are basic costs for people with Medicare.

2021 costs at a glance
Part A premiumMost people don’t pay a monthly premium for Part A (sometimes called “premium-free Part A”). If you buy Part A, you’ll pay up to $471 each month in 2021. If you paid Medicare taxes for less than 30 quarters, the standard Part A premium is $471. If you paid Medicare taxes for 30-39 quarters, the standard Part A premium is $259.
Part A hospital inpatient deductible and coinsuranceYou pay:$1,484 deductible for each benefit periodDays 1-60: $0 coinsurance for each benefit periodDays 61-90: $371 coinsurance per day of each benefit periodDays 91 and beyond: $742 coinsurance per each “lifetime reserve day” after day 90 for each benefit period (up to 60 days over your lifetime)Beyond lifetime reserve days: all costs
Part B premiumThe standard Part B premium amount is $148.50 (or higher depending on your income).
Part B deductible and coinsurance$203. After your deductible is met, you typically pay 20% of the Medicare-approved amount for most doctor services (including most doctor services while you’re a hospital inpatient), outpatient therapy, and durable medical equipment (dme)
Part C premiumThe Part C monthly premium varies by plan. Compare costs for specific Part C plans.
Part D premiumThe Part D monthly premium varies by plan (higher-income consumers may pay more). Compare costs for specific Part D plans.