Medicare cost is not one number. It is your Part B premium, plus any drug plan, supplement or Advantage premium, plus the deductibles and coinsurance you owe each time you use care. In Wichita, where the median household income is $64,620 (U.S. Census Bureau, 2024 American Community Survey 5-year estimates), a bill that lands a few hundred dollars above what you planned is a real problem.
Part A is premium-free for many people who worked long enough, but the other pieces depend on your income, your health and the plan you choose. This post lays out where the money goes so you can budget for the whole year, not just the first premium.
Medicare premiums: Part A, Part B, Part D and supplements
Original Medicare has two main parts. Part A covers hospital stays. Part B covers doctor visits, outpatient care and many tests and supplies.
Most people pay nothing for Part A because they or a spouse paid Medicare taxes for enough years. If you did not, you can usually buy Part A, and then it carries a premium.
Part B is different. Almost everyone pays a monthly premium, and it is usually taken out of a Social Security check if you receive one. The federal government sets the amount each year. Higher-income households pay an added surcharge, and it is based on an older tax return, not what you earn today. A one-time income bump, like cashing out retirement savings, can raise your Part B bill later even if your income drops back down.
Part D (prescription drug coverage), Medigap supplements and Medicare Advantage plans have their own premiums, set by private insurers. Some Advantage plans carry a low or zero premium, but you still pay your Part B premium on top of it.
What Original Medicare leaves you paying: deductibles, 20 percent and no cap
Premiums are only the entry fee. When you actually use care, Original Medicare charges you again.
- Part A: a deductible applies for each benefit period, and longer hospital stays bring daily charges.
- Part B: an annual deductible applies first. After that, you generally pay 20 percent of the Medicare-approved amount for most services.
- No out-of-pocket maximum: Original Medicare has no yearly cap on what you can owe. That 20 percent on a serious illness or a long course of treatment can be large.
A person with low premiums and no supplement can look cheap on paper and then get hit hard after one hospital stay.
Original Medicare also leaves some things out. It generally does not cover routine dental care, routine vision exams and eyeglasses, hearing aids, long-term custodial care like help with bathing and dressing, or most care received outside the United States. Some Advantage plans add dental, vision or hearing benefits, often with annual limits. If dental is your concern, the video on finding affordable dental coverage without extra costs covers that side.
If you want to compare plan types with a Wichita broker, you can see the Medicare options at 316 Health Insurance.
Medigap, Advantage or Original Medicare alone: comparing the real yearly cost
Most people who want predictable bills choose one of three paths.
Original Medicare plus a Medigap (supplement) plan. You pay a monthly Medigap premium, and the plan covers much of the 20 percent and the deductibles, depending on which lettered plan you pick. You can see any doctor who accepts Medicare. You add a separate Part D plan for prescriptions. Medigap premiums vary by plan letter, your age, your location and the insurer.
Medicare Advantage (Part C). A private plan replaces Original Medicare. It bundles hospital and medical coverage, and often drug coverage, with copays and an annual out-of-pocket maximum. Monthly premiums can be low, but you usually work within a network, and copays for specialists, hospital stays or therapy can add up.
Original Medicare alone. This has the lowest fixed cost and the highest risk. It can work for someone with other solid coverage, like a retiree plan, but it leaves the 20 percent exposed.
The cheapest monthly premium is not always the cheapest year. A better test is to ask for three figures on every option you consider:
- The total of 12 months of premiums, including Part B and any drug plan.
- What you would pay in a normal year, based on how often you see doctors and what your prescriptions cost.
- What you would pay in a bad year, meaning the plan's out-of-pocket maximum, or for Original Medicare with no supplement, a number you have to estimate yourself.
If you can live with the bad-year number, the cheaper plan may be right. If it would force you to sell something or skip care, the higher premium is buying real protection.
Why your Medicare cost depends on where you live
Medicare is federal, but your actual bill is local. Medicare Advantage and Part D plans are offered by county or region. Wichita is the county seat of Sedgwick County, and the plans sold there are not the same as those sold in the Tulsa area. Provider networks matter too. A plan that looks inexpensive costs more if your doctor or hospital is out of network.
316 Health Insurance is based in Wichita and serves both Wichita and Tulsa, so a comparison can start from the area where you actually live and get care.
Here is the detail national pages skip: what you are leaving behind changes your Medicare cost. Many people reach 65 while self-employed, on a small employer's plan, on COBRA or on an ACA Marketplace plan. Each situation affects when you should sign up for Part B and what happens to your current coverage. Missing your window can mean a late penalty added to your premium for as long as you have Part B, and COBRA generally does not protect you from it the way active employer coverage can. Marketplace premium subsidies also generally end once you are eligible for premium-free Part A.
Because 316 Health Insurance works across Medicare, ACA and Marketplace, small group, self-employed and COBRA coverage, one office can look at both sides of that handoff. The pages on COBRA and turning 26 options and health insurance for the self-employed explain how those situations work.
If you are sorting out how Medicare differs from coverage for lower-income households, see Medicare vs Medicaid: who gets which and what each covers. For a plain-language walkthrough, the video Solving the Medicare Mystery is a good place to start.
Frequently Asked Questions
How much does Medicare cost each month?
It depends on the parts you have. Part A is premium-free for many people. Part B has a standard monthly premium set each year, with higher amounts for higher incomes. Part D, Medigap and Advantage plans add their own premiums. Get the current-year figure for each piece, then add them together.
What is not covered by Medicare?
Original Medicare generally does not cover routine dental, routine vision, hearing aids, long-term custodial care or most care abroad. It also does not pay your deductibles or the 20 percent coinsurance on Part B services. Some Advantage plans and supplements fill part of that gap, so check each plan's details.
How much is covered by Medicare?
Original Medicare covers hospital care under Part A and medical services under Part B. After the deductible, Part B generally pays 80 percent of the approved amount, leaving you with 20 percent. There is no yearly out-of-pocket cap, which is why many people add a Medigap plan or choose Advantage.
How much will the Medicare Part B premium increase next year?
No reliable figure exists until the federal government announces it. Part B premiums are set annually, and the announcement typically comes in the fall before the new year. Until then, any number is a guess. Once it is published, compare the new premium to your budget before open enrollment.
Does my income change what I pay for Medicare?
Yes. Higher-income beneficiaries pay an income-related surcharge on Part B and Part D premiums. It is based on an older tax return. If your income dropped because of retirement or another life change, you can ask Social Security to review the decision.
Can I get help paying for Medicare?
Possibly. Programs exist for people with limited income and resources, including state Medicare Savings Programs and the federal Extra Help program for prescription costs. Eligibility depends on income and assets, and rules vary by state. Your state's Medicare counseling program can help you check.
Add up your Medicare cost with a Wichita broker
A general breakdown only goes so far. Your Medicare cost depends on your income, your doctors, your prescriptions and the plans offered where you live.
To compare options for your situation, visit the Medicare page at 316 Health Insurance or contact the office. You can also call (316) 282-3440, Monday through Friday, 9am to 5pm. After-hours appointments are available upon request.