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Part A is generally free for most people because you worked and paid Medicare taxes (at least 10 years usually). If not, you must buy part A (either $278 or $506 each month based on how long you paid Medicare Taxes) when first eligible (most people at 65) or pay a penalty if you sign up later (10% for each year you wait).

If you buy Part A, you must also sign up for Part B. Part B is what most people pay for. If you are drawing SS, it can come out of your SS payment. The cost of Part B is dependent upon income. It might be anywhere from $164.90 to $560.50 per person, per month based on your adjusted gross income (AGI). If your AGI goes up or down on your tax return, the cost for Part B does the same the following year. Part B also has a late enrollment penalty of 10% per year.

One can get around the penalty if you or your spouse is still covered by an employer, and you sign up within 8mths of ending that employment insurance.