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

The Part B premium — the amount you pay each month — is $174.70 in 2024 for most people. If your income is higher, you pay more. The annual deductible is $240, meaning you pay this amount out of your own pocket before Part B starts to cover anything. After you meet the deductible, Part B typically covers 80% of approved services, and you pay 20%.

These amounts change every January. The premium and deductible are set by Medicare each year based on program costs. If you enroll late — after your initial enrollment window — you may pay a permanent penalty on top of the standard premium. The penalty is 10% of the standard premium for each full year you could have had Part B but did not.

Key Takeaways

  • The standard Part B premium is $174.70 per month in 2024, but you pay more if your modified adjusted gross income exceeds certain thresholds.
  • You must meet a $240 annual deductible before Part B begins to cover services, and then you typically pay 20% of approved costs.
  • Premiums and deductibles change each year; check your Medicare notice in the fall to see what you will pay the following year.
  • Enrolling late in Part B can result in a permanent 10% monthly penalty added to your premium for each year you delayed.
  • Your actual out-of-pocket costs depend on which services you use and whether you have supplemental coverage or a Medicare Advantage plan.

How income affects your Part B premium

If your income is above a certain level, Medicare charges you a higher premium called an Income-Related Monthly Adjustment Amount (IRMAA). The income thresholds are based on your modified adjusted gross income from two years prior. For 2024, if you are single and your income is over $97,000, you pay more than the standard premium. If you are married filing jointly, the threshold is $194,000.

The higher you earn above these thresholds, the more you pay. Someone earning $120,000 as a single filer pays more than someone earning $100,000. The highest income bracket can result in a Part B premium of $560.50 per month in 2024 — more than three times the standard rate.

If your income drops — because you retire, lose a job, or have a major life change — you can ask Medicare to recalculate your IRMAA. You will need to report the change and provide documentation. This is called a life-changing event appeal.

When and how you pay your Part B premium

Most people pay their Part B premium by having it deducted automatically from their Social Security check each month. If you do not receive Social Security, Medicare sends you a bill. You can also set up automatic payments from your bank account if you prefer.

If you miss a payment, Medicare will send you a notice. You typically have a grace period to pay, but if you do not pay within three months, your Part B coverage can be terminated. Once terminated, you cannot re-enroll until the next general enrollment period (January 1 to March 31), and you will face a late-enrollment penalty.

What Part B actually covers after you pay

Part B covers doctor visits, outpatient hospital services, medical equipment, and preventive care. Once you meet your $240 deductible, Part B pays 80% of the Medicare-approved amount for most services. You pay the remaining 20%, called coinsurance.

Important: Part B does not cover everything. It does not cover routine dental care, vision exams, hearing aids, or long-term care. If you need these services, you will pay the full cost unless you have a separate plan or supplemental coverage.

Some preventive services — like annual wellness visits, cancer screenings, and vaccinations — are covered at 100% after you meet your deductible. Check with your doctor or call Medicare to confirm whether a specific service is covered before you go in.

Supplemental coverage and how it changes your costs

Many people buy a Medigap policy (supplemental insurance) to cover the 20% coinsurance that Part B leaves you responsible for. Medigap plans are sold by private insurance companies and have their own monthly premiums, but they can significantly reduce your out-of-pocket costs.

Alternatively, you can enroll in a Medicare Advantage plan instead of Original Medicare plus Part B. Medicare Advantage plans often have lower or zero premiums, but they typically have higher copays and coinsurance when you use services. The trade-off is different for each plan and each person.

If you have coverage through a current or former employer, that coverage may work alongside Part B. Do not drop employer coverage to enroll in Part B without understanding how the two interact — you may face penalties or gaps in coverage.

Part B costs if you delay enrollment

If you do not enroll in Part B when you first become may be able to access — usually at age 65 — you pay a late-enrollment penalty. The penalty is 10% of the standard Part B premium for each full 12-month period you could have had Part B but did not. This penalty is permanent and stays on your premium for as long as you have Part B.

There are exceptions. If you have coverage through an employer with 20 or more employees, you may not face a penalty when you eventually enroll. If you are still working and covered by your employer's plan, contact Medicare before your coverage ends to understand your options.

The penalty applies only if you delayed without a valid reason. If you enroll during your initial enrollment period — the three months before, the month of, and the three months after your 65th birthday — you pay no penalty.

Tracking your Part B costs throughout the year

Medicare sends you a notice each fall showing your premium and deductible for the coming year. Review this notice carefully. If the amount seems wrong — for example, if your income has dropped — you have a window to request a change.

Keep records of what you pay out of pocket for Part B services. These costs count toward your deductible and coinsurance. If you use many services in a year, tracking these amounts helps you understand your total healthcare spending and plan for the next year.

You can view your Part B costs and coverage details anytime by logging into your Medicare account at Medicare.gov or by calling 1-800-MEDICARE.

Frequently Asked Questions

Can I get Part B for free if I have low income?

No, Part B always has a premium. However, if your income is very low, you may be able to get help paying your premiums through a program called Medicaid or a Medicare Savings Program run by your state. Contact your state Medicaid office to learn whether you may have access to.

What happens if I cannot afford my Part B premium?

Contact Medicare at 1-800-MEDICARE to discuss your situation. Some people may have access to for premium information programs. You can also ask about setting up a payment plan if you have fallen behind. Do not ignore the bill — unpaid premiums can result in loss of coverage.

Does Part B cover my prescription drugs?

No. Prescription drug coverage is Part D, a separate plan you purchase from a private insurance company. Part B covers some drugs given to you in a doctor's office or hospital, but not medications you pick up at a pharmacy. You enroll in Part D separately during the annual enrollment period.

If I have Medicare Advantage, do I still pay Part B?

Yes. Medicare Advantage is an alternative way to receive your Part A and Part B benefits, but you still pay the Part B premium. Medicare Advantage plans may have additional copays and coinsurance, so your total costs depend on the specific plan and the services you use.

Will my Part B costs go up every year?

Usually, yes. Premiums and deductibles typically increase each year, though the amount varies. Medicare announces the new amounts in the fall. If your income increases, your IRMAA may also increase, raising your premium further.