Medicare Part B costs you a monthly premium, an annual deductible, and a percentage of the cost when you use services

The monthly premium for Medicare Part B in 2024 is $164.90 for most people, though some pay more based on their income. You also pay a $240 annual deductible before Medicare starts to pay its share. After you meet the deductible, you typically pay 20% of the cost for doctor visits, outpatient care, and other covered services, while Medicare pays 80%.

These amounts change each year. The premium and deductible are set by Medicare and announced in the fall for the following year. Your actual out-of-pocket costs depend on how much medical care you use and whether you have other insurance that helps pay Part B costs.

Key Takeaways

  • The standard Part B premium for 2024 is $164.90 per month, deducted from your Social Security check or paid directly to Medicare.
  • You pay a $240 annual deductible before Medicare begins covering Part B services.
  • After meeting your deductible, you pay 20% of the cost for most doctor visits and outpatient services.
  • Higher-income beneficiaries pay larger premiums, with amounts ranging from $164.90 to $560.50 per month depending on your income from two years prior.
  • Medigap or employer coverage can reduce or eliminate your out-of-pocket costs for Part B services.

How the monthly premium works

Your Part B premium is deducted automatically from your Social Security payment each month if you receive benefits. If you do not receive Social Security, Medicare bills you directly. The standard premium of $164.90 applies to most beneficiaries, but Medicare uses your income from two years earlier to determine whether you pay more.

If your modified adjusted gross income (MAGI) from two years ago was above a certain threshold, you pay an Income-Related Monthly Adjustment Amount (IRMAA) on top of the standard premium. For 2024, if your MAGI was above $97,000 as a single filer or $194,000 as a married couple filing jointly, you fall into a higher bracket. The premium can range from $164.90 up to $560.50 per month depending on your income level.

You can request a review if your income dropped significantly due to retirement, job loss, or death of a spouse. Medicare may lower your IRMAA if your current income is substantially different from the income they used to calculate it.

The annual deductible and coinsurance

Before Medicare pays anything for Part B services in 2024, you must pay the first $240 of costs yourself. This is your annual deductible. Once you reach $240 in out-of-pocket spending, Medicare begins to share the cost with you.

After you meet the deductible, you pay 20% of the Medicare-approved amount for most services. Medicare pays the remaining 80%. This coinsurance applies to doctor office visits, lab tests, imaging, and most outpatient procedures. Some preventive services, like annual wellness visits and certain screenings, have no coinsurance — Medicare covers them fully once you have met your deductible.

What Part B covers and what it does not

Part B covers doctor visits, outpatient hospital services, diagnostic tests, physical therapy, mental health services, and durable medical equipment like wheelchairs or oxygen. It also covers ambulance services and some home health care. Preventive services such as cancer screenings, cardiovascular screenings, and diabetes screenings are included with no coinsurance after you meet your deductible.

Part B does not cover dental care, vision exams, hearing aids, or routine foot care. It does not cover prescription drugs — that is Part D. Long-term care, custodial care, and most cosmetic procedures are also not covered. If you need services Part B does not cover, you pay the full cost yourself unless you have other insurance.

How other insurance affects your Part B costs

If you have a Medigap policy (also called supplemental insurance), it can pay some or all of your Part B deductible and coinsurance. The amount depends on which Medigap plan you choose. Some plans cover the full 20% coinsurance, while others cover a portion. Medigap premiums vary by plan and location, so your total out-of-pocket cost may be lower or higher than with Part B alone.

If you have employer coverage through a current or retired spouse's job, that coverage may pay Part B costs before Medicare does. You should tell your employer's benefits administrator that you have Medicare, because they need to coordinate payments correctly.

If you are in a Medicare Advantage plan (Part C), you still pay the Part B premium, but your deductible and coinsurance work differently. Most Advantage plans have lower out-of-pocket maximums than Original Medicare, meaning your costs are capped at a certain amount per year.

When Part B costs increase and how to plan ahead

Medicare announces the new premium and deductible amounts each October for the following year. The premium has increased most years, though the amount varies. The deductible also changes annually. You can find the current year's amounts on Medicare.gov or by calling 1-800-MEDICARE.

If you are approaching age 65 and not yet on Medicare, you should understand these costs before you enroll. If you delay enrolling in Part B without a valid reason, you may face a permanent penalty of 10% added to your premium for each year you delayed. The exception is if you have employer coverage — you can delay Part B without penalty as long as you are still working and covered by that employer plan.

Questions to ask your doctor or Medicare

Before a procedure or service, ask your doctor whether it is covered by Medicare Part B and what your out-of-pocket cost will be. Ask whether the service is considered preventive (no coinsurance) or diagnostic (subject to coinsurance). If you receive a bill that seems wrong, contact Medicare to verify the amount.

If you think your IRMAA is too high based on your current income, contact Social Security to request a review. Bring documentation of your income change, such as a recent tax return or a letter from your employer.

Frequently Asked Questions

Can I change my Part B coverage if the cost is too high?

You cannot drop Part B once you are enrolled without facing a penalty, unless you have other may have access to coverage such as employer insurance. If costs are a burden, explore Medigap plans or Medicare Advantage plans, which may offer lower out-of-pocket costs. You can also ask Medicare to review your IRMAA if your income has dropped.

What happens if I do not pay my Part B premium?

If you do not pay your premium, Medicare will send you a notice and give you a grace period to pay. If you do not pay within the grace period, your Part B coverage will end. You can restart it during the General Enrollment Period (January 1 to March 31), but you may face a permanent 10% penalty on your premium.

Does Part B cover telehealth visits?

Yes, Medicare Part B covers telehealth visits with your doctor. You pay the same coinsurance (20%) as you would for an in-person visit after you meet your deductible. The doctor's office must be set up to provide telehealth services, and the visit must be for a condition Part B normally covers.

Why did my Part B premium increase so much?

Your premium may have increased because your income from two years ago was higher, triggering an IRMAA surcharge. It may also have increased because the standard premium itself went up. If you believe the increase is wrong, request an IRMAA review from Social Security with documentation of your current income.

Is there a limit to how much I pay out of pocket for Part B?

Original Medicare Part B has no annual out-of-pocket maximum — you could theoretically pay 20% coinsurance indefinitely. However, Medicare Advantage plans do have out-of-pocket maximums, usually between $6,700 and $10,000 per year. Medigap plans also limit your costs depending on which plan you choose.