Part A Costs (Hospital Insurance)
Most Medicare beneficiaries pay $0 per month for Part A if they or their spouse worked and paid Medicare taxes for at least 10 years (40 quarters). Those with fewer qualifying quarters pay $278–$506/month in 2024.
Even with no premium, Part A has significant cost-sharing:
- Inpatient deductible: $1,632 per benefit period (not per year)
- Days 1–60: $0 coinsurance after deductible
- Days 61–90: $408/day coinsurance
- Lifetime reserve days: $816/day (60 days total, used once)
- Skilled nursing facility: First 20 days free, days 21–100 cost $204/day
Part B Costs (Medical Insurance)
The standard Part B premium is $174.70/month in 2024. This covers doctor visits, outpatient care, preventive services, and durable medical equipment.
The Part B deductible is $240 per year in 2024. After that, Medicare pays 80% and you pay 20% — with no out-of-pocket maximum under Original Medicare.
IRMAA: Income-Related Premium Surcharges
If your income exceeds certain thresholds (based on your tax return from 2 years prior), you pay higher Part B and Part D premiums. These Income-Related Monthly Adjustment Amounts (IRMAA) can be substantial:
| Individual Income | Part B Premium |
|---|---|
| Up to $103,000 | $174.70/month |
| $103,001 – $129,000 | $244.60/month |
| $129,001 – $161,000 | $349.40/month |
| $161,001 – $193,000 | $454.20/month |
| Over $500,000 | $594.00/month |
Part D Costs (Prescription Drugs)
Part D premiums vary by plan but average about $55.50/month in 2024. The annual deductible cannot exceed $545. After the deductible, cost-sharing applies until you reach the out-of-pocket maximum of $8,000 in 2024 (a new cap this year under the Inflation Reduction Act).
Important 2024 change: once you reach $8,000 out-of-pocket on drugs, Medicare covers 100% — the catastrophic phase with 5% cost-sharing has been eliminated.
Medigap Premiums
If you buy a Medigap policy to cover Original Medicare gaps, expect to pay $100–$300+/month depending on:
- Your age (premiums increase with age in most states)
- Plan type (Plan G covers most, Plan N has lower premiums with some copays)
- Your state (some states regulate Medigap pricing)
- Whether you smoke (insurers can charge more in most states)
Total Annual Cost Estimates
For a typical Medicare beneficiary on Original Medicare with Plan G Medigap and a Part D plan, expect to pay roughly $3,500–$6,000 per year in premiums alone, before any copays or drug costs. Medicare Advantage can reduce this significantly — some plans cost only the Part B premium (~$2,100/year) but with network restrictions and variable cost-sharing.