What Will Medicare Cost When You Turn 65? A Complete Breakdown

One of the most common questions we hear from people turning 65 is: what is Medicare actually going to cost me? The honest answer is: it depends on which Medicare path you choose. But here is a clear breakdown of what you can expect, so there are no surprises when your birthday month arrives.

The cost you pay automatically at 65 -- Part B premium

When you turn 65 and sign up for Medicare, you will automatically be enrolled in Medicare Part A (hospital coverage), which is free for most people who have worked at least 10 years and paid Medicare taxes. Part B (doctor visits and outpatient care) is not free -- it has a monthly premium that is automatically deducted from your Social Security payment. In 2026, the standard Part B premium is approximately $185 per month. This is the baseline Medicare cost for everyone turning 65, regardless of whether you choose Original Medicare or Medicare Advantage.

If you choose Medicare Advantage at 65 -- what you pay on top

Most Medicare Advantage plans have $0 additional monthly premium -- meaning you pay Part B ($185/month) and nothing extra for the Medicare Advantage plan itself. Some plans charge a small additional premium (typically $10 to $50/month) in exchange for richer benefits like lower copays or better drug coverage. When you use healthcare, you pay copays: typically $0 to $15 for a primary care visit, $35 to $50 for a specialist, and more for emergency or hospital care. The key advantage is the out-of-pocket maximum -- once your total costs for the year reach a cap (often $3,500 to $8,300 in-network), the plan pays 100% for the rest of the year.

If you keep Original Medicare at 65 -- what you pay

With Original Medicare, you pay 20% coinsurance (your share of the cost) for most covered services after meeting your Part B deductible ($257 in 2026). There is no annual out-of-pocket cap -- which means a serious illness could leave you owing tens of thousands of dollars. Most people who stay on Original Medicare purchase a Medigap (supplemental) policy, which costs $100 to $300 or more per month but covers most of that 20%. You would also need to purchase a separate Part D drug plan (typically $15 to $60/month). Add it up and Original Medicare plus Medigap plus Part D often costs significantly more in premiums than a $0-premium Medicare Advantage plan.

The prescription drug cost question -- critical at 65

This is one of the most financially important things to sort out when you turn 65. If you take prescriptions, you need drug coverage (Part D) from day one. Medicare Advantage plans usually bundle drug coverage at no extra premium. With Original Medicare, you buy a separate Part D plan. Either way, the key step before you enroll is to have a licensed agent check your specific medications against each plan's formulary -- the list of drugs the plan covers and at what cost. A drug that costs $15/month on one plan might cost $200/month on another. This comparison is completely free and takes a few minutes.

More turning-65 Medicare guides

• Turning 65 and Need Dental Coverage? Medicare Advantage Explained
• Turning 65: Should You Choose Medicare Advantage or Original Medicare?
• Turning 65 Medicare Enrollment: Your 7-Month Window Explained
• Turning 65: Extra Benefits You Did Not Know Medicare Advantage Includes