Medicare Budget Worksheet — Calculate Your Real Monthly Cost

Step 0 — Check for IRMAA (Income-Related Adjustment)

Based on your income from 2 years prior

IRMAA is a surcharge added to your Part B and Part D premiums if your income exceeds the thresholds below. Check your 2024 MAGI (Modified Adjusted Gross Income) if enrolling in 2026.

2024 Income (Single)	2024 Income (Joint)	Part B Monthly	Part D Add-On
≤ $103,000	≤ $206,000	$202.40	$0.00
$103,001–$129,000	$206,001–$258,000	$244.60	+$12.90
$129,001–$161,000	$258,001–$322,000	$349.40	+$33.30
$161,001–$193,000	$322,001–$386,000	$454.20	+$53.80
$193,001–$499,999	$386,001–$749,999	$559.00	+$74.20
≥ $500,000	≥ $750,000	$594.00	+$81.00

Premiums shown are 2024 standard amounts. They adjust annually. If you believe your income has dropped significantly, you may appeal IRMAA using Form SSA-44.

Part A — Hospital Insurance

Usually $0 if you worked 10+ years

Part A Premium Free if you or your spouse paid Medicare taxes for 40+ quarters (10 years). If not, up to $505/month in 2024.

Part B — Medical Insurance

Everyone pays this

Part B Premium Standard 2026 rate: $202.40/month. Use the IRMAA table above if your income exceeded $103k (single) / $206k (joint) in 2024.

Part C / Medigap — Supplement or Medicare Advantage

Choose one path — not both

Option A: Medicare Advantage Premium Many plans are $0/month but have copays/deductibles. If your plan has a monthly premium, enter it here. (Enter $0 if using Medigap instead.)

Option B: Medigap Supplement Premium Plan G typically runs $80–$200/month depending on age and carrier. Covers most OOP costs under Original Medicare. (Enter $0 if using Advantage instead.)

Part D — Prescription Drug Coverage

Separate from Medicare Advantage drug plans

Part D Plan Premium Standalone Part D plans typically run $20–$60/month. Varies by plan and formulary. Skip if your Medicare Advantage plan includes Part D.

Part D IRMAA Surcharge From the IRMAA table above. Enter $0 if income was below thresholds.

Estimated monthly drug copays What you typically pay out-of-pocket each month for your prescriptions.

Dental, Vision & Hearing

Not covered by Original Medicare — budget separately

Dental plan premium Stand-alone dental plans run $20–$50/month. Some Medicare Advantage plans include limited dental. Enter $0 if included in Advantage.

Vision plan premium Stand-alone vision: $10–$25/month. Some MA plans include a vision allowance instead.

Hearing aids / plan (monthly estimate) Average hearing aids: $2,000–$7,000 per pair. Divide by 36–60 months for a monthly budget number. Some MA plans include a hearing benefit.

Out-of-Pocket Reserve (monthly set-aside)

Copays, deductibles, unexpected care

Monthly OOP reserve If on Original Medicare with no Medigap, there is no OOP maximum. A $150–$300/month reserve is a reasonable buffer for copays, deductibles, and unexpected costs. With Plan G Medigap, this can be much lower.

Note: All amounts are estimates based on 2024 standard rates. Actual premiums vary by plan, carrier, location, and income. This worksheet is general educational information, not individualized insurance, tax, or legal advice. Verify current premiums directly with plans or at Medicare.gov.

What will Medicare actually cost you per month?