Understanding the different parts of Medicare
To accurately determine your costs at age 65, you must understand Medicare's different components. Original Medicare consists of Part A (Hospital Insurance) and Part B (Medical Insurance). Most people also enroll in either a Medicare Advantage Plan (Part C) or a Medicare Supplement (Medigap) policy along with a Part D (Prescription Drug) plan. Each part has its own set of costs, which can include premiums, deductibles, coinsurance, and copayments.
Medicare Part A (Hospital Insurance) costs in 2025
For the majority of people turning 65, the premium for Medicare Part A is $0. This is because they, or their spouse, have worked and paid Medicare taxes for at least 10 years (40 quarters). If you or your spouse did not pay Medicare taxes for this duration, you may have to pay a monthly premium to get Part A. In 2025, this premium is $285 per month for those with 30-39 quarters of work and $518 per month for those with fewer than 30 quarters. The Part A deductible per benefit period is $1,676 in 2025.
Medicare Part B (Medical Insurance) premiums in 2025
Almost all enrollees must pay a monthly premium for Part B. For 2025, the standard Part B monthly premium is $185. Higher earners pay more based on IRMAA. The annual Part B deductible for 2025 is $257, and you typically pay 20% coinsurance after that.
Income-related monthly adjustment amount (IRMAA)
If your modified adjusted gross income (MAGI) is above a certain level, you'll pay an additional amount on top of your standard Part B premium. This extra charge is known as IRMAA and is based on your tax return from two years prior. For 2025, IRMAA is determined by your 2023 MAGI. For example, an individual filer with a MAGI over $106,000 in 2023 will pay more than the standard $185 monthly premium in 2025.
Comparison of Medicare coverage options at 65
Beyond Original Medicare, you have choices that affect your costs and coverage.
| Coverage Option | How it Works | Costs to Consider (in addition to Part B premium) |
|---|---|---|
| Original Medicare (Parts A & B) | The government pays your claims directly for covered services. | Part A deductible ($1,676 per benefit period in 2025), Part B deductible ($257 annually in 2025), and 20% coinsurance for most Part B services. |
| Original Medicare + Medigap (Supplement) + Part D | Medigap pays some or all of your Original Medicare out-of-pocket costs, while Part D covers prescription drugs. | Medigap premiums (can range from $30–$550+ monthly depending on the plan) and Part D plan premiums. |
| Medicare Advantage (Part C) | A private insurance company provides your Part A, Part B, and often Part D coverage. | Can have low or even $0 premiums, but you pay copayments, coinsurance, and potentially deductibles for services. You must continue to pay your Part B premium. |
Other costs and late enrollment penalties
Even with coverage, other out-of-pocket expenses can apply, such as copayments and deductibles that vary by plan. If you delay enrolling in Medicare when first eligible at age 65, you may face late enrollment penalties. For Part B, there's a permanent 10% penalty for each 12-month period you were eligible but not enrolled. A Part D late enrollment penalty is also added to your premium if you didn't have other creditable drug coverage. Special Enrollment Periods may help avoid penalties if you had job-based coverage.
Conclusion
The cost of Medicare at age 65 is complex and depends heavily on your individual situation, including your work history, income, and desired coverage level. While most people get premium-free Part A, the standard 2025 Part B premium is $185, plus potential IRMAA surcharges for higher earners. Your overall healthcare costs will be most influenced by your choice of supplemental coverage—either a Medigap policy plus Part D, or an all-in-one Medicare Advantage plan. Careful consideration of these options and timely enrollment are key to managing your healthcare expenses in retirement.
For more detailed information, you can visit the official Medicare website medicare.gov.
