What Does Medicare Cost?

Turning 65 often comes with one big question: “How much is Medicare actually going to cost me to have the coverage?” The answer depends on which parts of Medicare you enroll in, your work history, the prescription drug plan you choose, and even your income. While some people assume Medicare is free, there are still premiums and other costs to think about. Let’s break down the cost of Medicare Part A, Part B, Part D, and something called IRMAA.

Medicare Part A: Hospital Coverage - inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care.

Is Medicare Part A Free?

For most people, yes.  If you or your spouse worked and paid Medicare taxes for at least 10 years (40 quarters), you can usually get Medicare Part A with no monthly premium.  That is why you may hear people say that Medicare Part A is “free.” In reality, you already paid for it through payroll taxes while you were working.

What If You Did Not Work 10 Years?

If you did not work long enough to qualify for premium-free Part A, you may still be able to buy it.  In 2026:

• If you worked 30–39 quarters, Part A costs $311 per month.

• If you worked fewer than 30 quarters, Part A costs $565 per month.

That can add up quickly, which is why it is important to understand whether you qualify based on your own work history or your spouse’s.  Even if you get Part A with no premium, it does not mean hospital care is free. There is still a deductible and other out-of-pocket costs if you are admitted to the hospital.

Medicare Part B: Medical Coverage - doctor visits, outpatient care, lab work, preventive care, physical therapy, durable medical equipment, and more.

Unlike Part A, almost everyone pays a monthly premium for Part B. In 2026, the standard Medicare Part B premium is $202.90 per month.  Most people have this amount taken directly out of their Social Security check.  Part B also has an annual deductible of $283. After you meet the deductible, Medicare generally pays 80% of approved costs and you pay the remaining 20% unless you have other coverage, such as a Medicare Supplement or Medicare Advantage Plan.

Medicare Part D: Prescription Drug Coverage -  prescription medications.

There is not one standard Part D premium because every drug plan has its own monthly cost.  Some plans may cost very little, while others cost more depending on the medications they cover and the pharmacy network they use.  In 2026, the national base premium used by Medicare is $38.99 per month. However, the actual premium for the plan you choose may be higher or lower.

If you have a Medicare Advantage Plan that includes drug coverage, the cost of Part D is usually included in the plan premium.  If you choose Original Medicare, you can buy a stand-alone Part D drug plan separately.  The most important thing is not simply choosing the lowest premium. A plan that costs a little more each month may save you money if it covers your medications better.

What Is IRMAA? - Income-Related Monthly Adjustment Amount.

This is an extra amount that some people pay for Medicare Part B and Part D if their income is above certain limits.  IRMAA is based on the income shown on your tax return from two years earlier. For 2026, Medicare looks at your 2024 tax return.  If your income is above the limit, you pay the regular Part B premium plus an extra amount. You also pay an extra amount for Part D in addition to your drug plan premium.

2026 IRMAA Income Limits

You do not pay IRMAA if your 2024 income was:

• $109,000 or less if you filed an individual tax return

• $218,000 or less if you filed jointly

If your income was higher than that, your Medicare costs increase.

IRMAA Chart 2026

One thing that surprises some people is that the Part D IRMAA is added on top of the premium for your drug plan. For example, if your Part D plan costs $40 per month and your IRMAA amount is $37.50, your total monthly drug cost becomes $77.50.

Can IRMAA Be Reduced?

Sometimes, yes.  If your income has gone down because of a major life event, such as:

• Retirement

• Marriage or divorce

• Death of a spouse

• Loss of income-producing property

You may ask Social Security to lower or remove your IRMAA  by filing Form SSA-44.

The good news is that you do not have to figure it all out on your own. Understanding your work history, income, prescriptions, and medical needs can help you choose the Medicare coverage that fits you best and avoid unpleasant surprises later.