Medicare Part B is paid through monthly premiums deducted from your Social Security check

Most people pay for Medicare Part B through a monthly premium that comes directly out of their Social Security benefit. If you don't receive Social Security yet, Medicare bills you quarterly instead. The amount you pay depends on your income from two years ago — not your current income — and whether you're new to Medicare or already enrolled.

Part B covers doctor visits, outpatient care, lab tests, and medical equipment. It's optional, but if you delay signing up when you're first may be able to access, you'll pay a permanent penalty for as long as you have Medicare. The standard premium changes each year; your local Social Security office or Medicare.gov can tell you the exact amount for your situation.

Key Takeaways

  • Part B premiums are usually taken directly from your Social Security payment each month, or billed quarterly if you don't receive Social Security.
  • Your premium amount is based on your income from two years prior, so changes in your current income won't affect what you pay this year.
  • Higher earners pay more through Income-Related Monthly Adjustment Amounts (IRMAA), which can add $70 to $350+ per month depending on your filing status and income.
  • If you delay enrolling in Part B when first may be able to access, you'll pay a 10% penalty on your premium for each full year you waited, for the rest of your life.
  • You can change your payment method or update your income situation by contacting Social Security or calling Medicare at 1-800-MEDICARE.

Standard premiums and how they're set each year

Medicare sets a standard Part B premium amount annually, usually announced in the fall for the following year. This base premium covers the cost of doctor visits and outpatient services. The standard premium varies from year to year based on the cost of providing those services.

If you're new to Medicare at 65, you'll pay the standard premium unless your income is high enough to trigger an additional charge. Most people who worked and paid Medicare taxes throughout their careers pay only the standard amount. You can find the current year's standard premium on Medicare.gov or by calling 1-800-MEDICARE.

Income-related premiums (IRMAA) for higher earners

If your income exceeds certain thresholds, you'll pay more than the standard premium through a surcharge called Income-Related Monthly Adjustment Amount (IRMAA). Medicare uses your Modified Adjusted Gross Income (MAGI) from your tax return from two years ago to calculate this. For 2024, single filers with income over $97,000 and married couples filing jointly over $194,000 begin paying extra.

The surcharge increases in brackets — the higher your income, the more you pay. A single person earning $250,000 might pay $350 or more extra per month on top of the standard premium, while someone earning $120,000 might pay $70 extra. These thresholds and amounts change yearly, so check your Social Security statement or Medicare.gov to see where you fall.

If your income dropped significantly — through retirement, job loss, or divorce — you can request that Medicare recalculate your IRMAA using your current year's income instead. You'll need to file a form called the Life-Changing Event form with Social Security and provide documentation of the change.

How premiums are deducted from Social Security

If you receive Social Security benefits, your Part B premium is automatically subtracted from your monthly payment. You see the deduction on your Social Security statement each month. This is the most common payment method and requires no action on your part once it's set up.

Social Security cannot deduct more than your full benefit amount for Medicare premiums. If your Part B premium plus Part A premium (if you pay one) would exceed your Social Security check, Social Security pays Medicare what it can and bills you for the remainder. This situation is rare but can happen if you have high IRMAA charges.

Quarterly billing if you don't receive Social Security

If you're not yet receiving Social Security benefits when you turn 65, or if you've delayed claiming, Medicare sends you a bill every three months for your Part B premium. You'll receive a statement showing what you owe and payment instructions. You can pay by mail, phone, or online through Medicare.gov.

Once you start receiving Social Security, you can switch to having your premium deducted automatically. Contact Social Security to make this change. If you miss a quarterly payment, Medicare will send a reminder, and you'll need to pay the full amount owed before coverage continues without interruption.

Late enrollment penalties and how they work

If you don't sign up for Part B when you first become may be able to access at 65, and you don't have other health coverage that counts as "creditable coverage," you'll pay a permanent penalty. The penalty is 10% of the standard premium for each full 12-month period you delayed. If you waited three years, you'd pay 30% extra on top of the standard premium for the rest of your life.

The only way to avoid this penalty is to sign up during your initial enrollment period (the three months before, the month of, and three months after your 65th birthday) or during a Special Enrollment Period if you had may have access to coverage. If you missed your window and now want to enroll, you can do so during the General Enrollment Period (January 1 through March 31 each year), but the penalty will explore.

Changing your payment method or updating your information

You can change how you pay your Part B premium at any time. If you want to switch from automatic deduction to quarterly billing, or vice versa, contact Social Security at 1-800-772-1213 or visit your local Social Security office. You can also call Medicare at 1-800-MEDICARE to discuss payment options.

If your income changed significantly, you have 60 days from the date of the life-changing event to request a recalculation of your IRMAA. Events that may have access to include retirement, loss of income, divorce, death of a spouse, or loss of a job. You'll need to submit documentation and the Life-Changing Event form to Social Security.

Frequently Asked Questions

What if I can't afford my Part B premium?

If you have limited income, you may be able to get help through Medicaid or the Medicare Savings Program, which is run by your state. These programs can pay your Part B premium and other out-of-pocket costs. Contact your state Medicaid office or call 1-800-MEDICARE to learn whether you may have access to based on your income and resources.

Can I get a refund if I overpaid my Part B premium?

Yes. If you've overpaid — for example, if you paid quarterly bills and then switched to Social Security deduction — Medicare will credit the overpayment to your future premiums or issue a refund. Contact Medicare at 1-800-MEDICARE with your payment details, and they'll review your account.

Does my Part B premium cover everything, or do I still have costs?

Your Part B premium covers the insurance itself, but you'll still have a yearly deductible, copayments for visits, and coinsurance for services. Part B doesn't cover everything — for example, it doesn't cover dental, vision, or hearing aids. Many people buy a Medigap or Medicare Advantage plan to cover these gaps.

What happens to my Part B premium if I move to another state?

Your premium amount doesn't change if you move. It's based on your income, not your location. However, your coverage area may change, and some plans may not be available in your new state. Contact Medicare to update your address and review your coverage options in your new location.

Can I suspend my Part B coverage to lower my costs?

You can drop Part B if you have other may have access to coverage, such as employer health insurance. However, if you drop it and later re-enroll, you'll pay the late enrollment penalty unless you had creditable coverage the entire time you were without Part B. Talk to your employer's benefits office before making this decision.