Medicare premiums. Medicare beneficiaries have to pay premiums and a variety of other out-of-pocket costs. Most retirees don't pay a premium for Medicare Part A, but there is a ,340 deductible in 2018 and additional charges for long hospital stays. Most beneficiaries pay the standard Medicare Part B premium of 4 per month in 2018, but higher income retirees pay more. "If your income is at least ,000 or more, then you pay the income related premium, which is indexed and rises with income," says Tricia Neuman, director of the Program on Medicare Policy at the Kaiser Family Foundation. Medicare Part B has a 3 deductible in 2018, after which beneficiaries are generally responsible for 20 percent of the cost of most doctor's services. The premium for Medicare Part D prescription drug coverage varies depending on the plan you select. The average Medicare Part D premium is .50 per month in 2018, and plans can charge deductibles of up to 5. Many retirees select Medicare supplemental insurance plans that cover some of these cost-sharing requirements in exchange for a monthly payment.