When Is Medicare Free, and How Much Do Most People Pay?
Medicare Part A is usually free, but you'll likely pay about $175 per month for Part B.
If you have a Part D, Medicare Advantage or Medicare Supplement plan, you'll have an extra monthly cost on top of paying for Part B. Although nearly everyone will get free Medicare Part A, the total cost for all your Medicare will typically be between $175 and $371 per month in 2024. Some costs can be lowered or eliminated if you have a low income.
How much does Medicare usually cost?
Medicare costs between $175 and $371 per month, depending on the options you choose.
What you pay depends on what parts of Medicare you have. The primary coverage from Medicare comes from Parts A and B. These come from the federal government. Most people don't pay for Part A. The monthly fee for Part B is set each fall by the Centers for Medicare & Medicaid Services (CMS).
- Cost for Part A: Usually free. About 99% of people get Medicare Part A for free. Part A covers hospital care if you are 65 or older. You get free Part A as long as you or your spouse worked for at least 10 years (40 quarters). That's because you paid Medicare taxes during your working years. If you have a disability, you can get free Medicare Part A without meeting the work requirements.
- Cost for Part B: $174.70 per month. Most people pay this standard fee, which covers medical care outside of hospitals. This includes doctor appointments, lab tests and diagnostics.
There are other types of Medicare coverage that can be added to Parts A and B. For example, you can add Part D to cover prescription drugs or a Medicare Supplement policy to get extra coverage for medical bills. That's why your total Medicare costs will depend on the combination of Medicare plans you choose and the cost for each type of coverage.
The cheapest option is usually to pay for Medicare Part B and enroll in a $0 Medicare Advantage bundle with drug coverage.
But if you need frequent medical care, getting the cheapest combination of plans is not usually a good idea. It can be worth it to pay for Part B and then add on Medicare Supplement and Part D drug coverage. Your monthly bills might be higher, but you could save enough on medical costs to come out ahead.
Type of Medicare coverage | What affects prices | Typical monthly cost |
|---|---|---|
| Part A (hospital care) | 99% of enrollees get coverage for free | $0 |
| Part B (medical care) | Rate set annually by the government | $174.70 |
| Part C (Advantage bundle) | Costs vary based on the plan you choose | $27 |
| Part D (prescriptions) | $59 | |
| Medicare Supplement | $137 |
Medicare Advantage (Part C), Part D and Medicare Supplement plans come from private insurance companies. The costs for these plans vary based on where you live and what company you choose.
For example, a Medicare Advantage plan with prescription drug coverage costs an average of $27 per month. But in most places, there's at least one plan available that has no monthly rate. The cost for Medicare Supplement plans, also called Medigap plans, varies based on the plan you choose, whether or not you signed up when you were first able to and if your state allows age to be used when setting prices.
Because of the cost changes, it can be helpful to compare plan options when you initially sign up for Medicare and to review your choices every year. This helps you get the best deal based on your available plan options and current medical needs.
What is premium-free Medicare Part A?
Most people qualify for no-cost Medicare Part A because they paid Medicare taxes for 10 years or are eligible for a waiver.
If you are 65 or older, you have to meet the work requirement to get free Part A. But if you qualify for Medicare because of a disability, you are automatically eligible for free Part A.
Type of Medicare enrollee | Work requirement for free Medicare Part A |
|---|---|
| Seniors | You or a spouse having worked at least 10 years |
| Those who have a disability | No work requirement |
The small percentage of enrollees who do not meet the work criteria pay between $278 and $505 per month for Medicare Part A.
Who qualifies for free Medicare Part B?
Medicare Part B is only free if you have a low income and are enrolled in one of the Medicare Savings Programs for financial assistance.
Eligibility for these programs varies by state. Some states make it easier to qualify because of higher income limits or by eliminating the asset requirement.
In 2024, you'll typically be eligible for the Medicare Savings Programs if you earn less than $20,580 per year as an individual or less than $27,840 per year as a married couple. Some states will automatically enroll you if you are eligible. Check with your state's Medicaid office to see if you're eligible for one of the three Medicare Savings Programs that reduce the cost of Medicare Part B.
Medicare Savings Program | Typical income limit (indiv.) |
Typical asset limit (indiv.)
|
|---|---|---|
| Qualified Medicare Beneficiary (QMB) | $15,300 per year | $9,430 |
| Specified Low-Income Medicare Beneficiary (SLMB) | $18,312 per year | $9,430 |
| Qualifying Individual (QI) | $20,580 per year | $9,430 |
The Qualified Medicare Beneficiary (QMB) program can pay for the monthly plan costs as well as medical costs including your deductible, coinsurance and copays. The Specified Low-Income Medicare Beneficiary (SLMB) and Qualifying Individual (QI) programs will only help pay the monthly cost of Part B, but you still have to have Part A to qualify.
You can also save by being dual enrolled in Medicare and Medicaid. In many states, you'll qualify for Medicaid if you earn less than $20,783. Being in both programs can reduce or eliminate your health care costs. And you can still enroll in a Medicare Savings Program to reduce your monthly cost for Medicare Part B, as long as you also have Part A.
Can you get free Medicare Advantage (Part C)?
Yes, $0 Medicare Advantage plans with prescription drug coverage are available in 98% of the U.S. counties where plans are sold.
$0 Medicare Advantage plans don't have a monthly rate, although you do still pay for Part B. These plans typically include coverage for hospitalization, medical care, medications and many add-on perks.
With some no-fee Medicare Advantage plans, you may pay more when you need medical care. But if you don't go to the doctor often, you could save money overall. And there are high-quality plans that have no monthly rate or a low monthly rate. You don't have to sacrifice customer satisfaction to get a low monthly cost.
Access to these cheap Medicare Advantage plans is based on where you live. Unfortunately, there isn't any way to get a free plan unless one is offered in your area.
Is Medicare Part D free?
Most people don't have access to free Medicare Part D plans.
In most states and counties, you will have a monthly fee for Medicare Part D. The national average cost for Part D is $59 per month, but cheaper plans are usually available depending on where you live. Free Medicare Part D plans are offered in some areas, but they aren't common.
However, $0 prescription drug coverage is available through the Extra Help program if you have a low income. You have to meet certain criteria to qualify for Extra Help. In 2024, you'll qualify for Extra Help if you made less than $22,590 as an individual and have no more than $17,220 in other resources.
Eligibility for Extra Help | Annual income limit | Resources limit (cash, stocks or bonds) |
|---|---|---|
| Individual | $22,590 | $17,220 |
| Married couple | $30,660 | $34,360 |
With the Extra Help program, those who have low incomes can qualify for either full or partial benefits. The program can reduce the cost of your plan and what you pay for medications. With full benefits, you'll pay no more than $4.50 for each generic prescription and $11.20 for each brand-name drug that's covered.
You may also be able to get free prescription drug benefits by choosing a Medicare Advantage bundle instead of a stand-alone Medicare Part D plan. However, this option is only possible if $0 plans are offered in your area. And choosing a bundle plan will also affect your health care benefits.
Can you get free Medicare Supplement (Medigap) plans?
No, Medigap plans always have a cost.
The average cost of a Medigap plan is $137 per month, although the price varies depending on the specific plan you buy. Monthly Medigap rates are expensive because they help pay for so many of your medical costs. In some cases, a Medigap plan and Original Medicare can pay for almost all of your medical bills.
Despite the monthly cost, Medicare Supplement plans are a good choice if you have complex or expensive medical needs. The coverage they provide, along with Original Medicare, usually outweighs the monthly cost. With a Medigap plan, you can go to any doctor that accepts Medicare, rather than having a limited network of doctors and hospitals with a Medicare Advantage plan.
If you have a low income and qualify for Medicaid, you probably don't need a Medicare Supplement plan. Your Medicaid benefits will pay for the extra costs from Medicare, helping you reduce or eliminate your medical bills, although there may be some exceptions.
For those who don't qualify for Medicaid, there are three ways to reduce the cost of a Medigap plan.
- Choose a plan with less coverage like Plan K, which costs an average of $77 per month. Just remember that the cheaper options usually don't have as much coverage.
- Choose a high-deductible plan, which won't provide benefits until you reach the $2,800 deductible. That means you probably won't have the extra coverage during routine care, but you will get help from the plan if you need an expensive treatment.
- Choose a Select plan that limits your supplemental benefits to in-network medical providers rather than covering any providers who accept Medicare.
If you have a high income, your costs for Medicare will be higher
You'll pay more for Part B and Part D in 2024 if the income on your 2022 tax return is above $103,000 as an individual or above $206,000 on a joint tax return. You'll use your adjusted gross income minus some allowable deductions and tax penalties. This is called your modified adjusted gross income (MAGI).
The higher cost is based on your income taxes from two years ago and is called the income-related monthly adjustment amount (IRMAA).
Type of Medicare | Cost for high-income earners |
|---|---|
| Part B (medical care) | $244.60 to $594.00 per month |
| Part D (prescription drugs) | An extra $12.90 to $81.00 per month on top of your plan cost |
Why do you have to pay for Medicare?
After paying into Medicare while working, many people are surprised to find out that Medicare isn't free once they retire.
The payroll taxes you paid when working only pay for a third of the cost of the Medicare program. The monthly cost that enrollees pay for Medicare totals 15% of the program's budget.
This means that the benefits you get from the Medicare program are worth much more than what you pay each month.
How to save on Medicare costs
Even though not everyone is able to get Medicare for free, there are some steps you can take to avoid overpaying.
- Make sure you're getting all of the discounts you're eligible for
- Sign up when you're first eligible to avoid late-enrollment penalties
- Look for Medicare Advantage plans with rewards programs for healthy activities
- Look for Medicare Advantage plans with a Part B giveback program to reduce how much you pay for Part B
- Work with a financial advisor to limit the high-income Medicare surcharge
An estimated 30% to 45% of those who are eligible for low-income discount programs are not enrolled, showing how important it is to check your eligibility for each savings program.
Frequently asked questions
Is Medicare free for seniors age 65 and older?
No, most seniors pay between $175 and $371 per month depending on what kinds of Medicare coverage they buy. However, seniors who have a low income can qualify for free or reduced-cost Medicare.
Is Medicare free for the disabled?
Medicare is not always free for those who qualify through a disability. If you have a disability, you can get Medicare Part A for free without meeting the typical work requirement. If you also have a low income, you may be eligible for discount programs to reduce or eliminate the cost of Medicare Part B and Part D.
Do you have to pay for Medicare?
Yes, most people pay $174.70 per month for Medicare Part B and may pay more if they choose additional coverage options. Part A is free if you worked for 10 years or more.
Who qualifies for free Medicare Part A?
About 99% of seniors get Medicare Part A for free because they worked for at least 10 years. During that time, they paid payroll taxes that pay for Part A coverage. Some people with disabilities also get free Medicare Part A.
Can I get Medicare Part B for free?
If you have a low income, you can qualify for free Medicare Part B benefits. Eligibility for a Medicare Savings Program varies by state, with a typical individual qualifying with an annual income of less than $20,580.
Methodology and sources
Medicare Advantage rates for 2024 are from the Centers for Medicare & Medicaid Services (CMS) public use files. Rates include only plans with prescription drug coverage. Medicare-Medicaid plans, Medicare savings account (MSA) plans, employer-sponsored plans, special needs plans (SNPs), sanctioned plans, Program of All-inclusive Care for the Elderly (PACE) plans and prepayment plans (HCPPs) were excluded from our analysis.
Part D rates are also from the 2024 CMS public use files. Rates exclude sanctioned and employer-sponsored plans.
Medicare Supplement rates are based on 2024 data for private insurance companies. Average costs are for a 65-year-old nonsmoking woman who does not have a household discount and signed up for a plan when she was first eligible and didn't have to answer health questions. States that have their own Medigap system and Select plans are excluded from average rates.
Other sources include:
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