Medicare Part B costs you a monthly premium, an annual deductible, and a percentage of most services after that

The standard Medicare Part B premium for 2024 is $164.90 per month if you have higher income, or less if your income is below certain thresholds. Most people pay this amount directly from their Social Security check. You also pay a $240 annual deductible before Medicare starts to cover doctor visits and outpatient services. After you meet the deductible, you typically pay 20 percent of the cost for most services — Medicare pays 80 percent.

The exact amount you pay depends on your income from two years ago. If your income was higher in 2022, you may pay more in 2024. If your income drops — because you retire, lose a job, or have a major life change — you can ask Medicare to recalculate your premium based on your current income.

Part B also covers preventive services like annual wellness visits and certain screenings at no cost to you after you meet your deductible. But if you need lab work, imaging, or specialist visits, the 20 percent coinsurance applies.

Key Takeaways

  • The standard Part B premium is $164.90 per month in 2024, but you may pay less if your income is below $97,000 (single) or $194,000 (married filing jointly).
  • You pay a $240 annual deductible before Medicare covers most doctor and outpatient services.
  • After your deductible, you pay 20 percent coinsurance for most services; Medicare covers the other 80 percent.
  • If your income drops due to retirement or job loss, you can request that Medicare recalculate your premium based on current income rather than income from two years prior.
  • Preventive services like wellness visits and screenings are covered at no cost after you meet your deductible.

How income affects your Part B premium

Medicare uses your Modified Adjusted Gross Income (MAGI) from your tax return two years before the current year to set your premium. For 2024 coverage, Medicare looked at your 2022 income. If you earned less than $97,000 as a single filer or $194,000 as a married couple filing jointly, you pay the standard $164.90 premium.

If your income was higher, your premium increases in brackets. Someone with income between $97,001 and $123,000 (single) pays $230.80 per month. The brackets continue upward; the highest earners pay $560.50 per month. These amounts change each year.

The income threshold that matters is the one from two years ago, which can work in your favor if your income has recently dropped. If you retired, lost a job, or had a major life event that reduced your income, you can contact Social Security and ask them to use your current-year income instead. You will need to provide documentation of the change — a retirement letter, termination notice, or divorce decree, depending on what happened.

What Part B covers and what you pay

Part B covers doctor visits, outpatient hospital services, medical equipment, and some home health care. Once you meet your $240 annual deductible, you pay 20 percent coinsurance for most of these services. A doctor visit that costs $150 means you pay $30 after your deductible is met.

Preventive services — including your annual wellness visit, certain cancer screenings, diabetes tests, and cardiovascular screenings — are covered at no cost to you. You do not pay the 20 percent coinsurance for these specific services, though you still need to meet your deductible for other services.

Part B does not cover dental, vision, or hearing care. It also does not cover prescription drugs — that is Part D. If you need these services, you will need separate coverage or pay out of pocket.

When Part B premiums are deducted from your check

If you receive Social Security, your Part B premium is automatically deducted from your monthly payment. Most people do not write a separate check. If you do not yet receive Social Security, Medicare will bill you directly by mail, usually monthly.

If you delay enrolling in Part B past age 65 and do not have other creditable coverage, you may face a permanent penalty — your premium increases 10 percent for each year you were may be able to access but did not enroll. This penalty stays with you for life, so enrolling on time matters financially.

Part B costs compared to other Medicare parts

Part A (hospital insurance) has no monthly premium for most people, but it has a deductible of $1,632 per hospital stay in 2024. Part B is the outpatient piece and costs the monthly premium plus the annual deductible and coinsurance. Part D (prescription drugs) has its own separate premium, which varies by plan and ranges from roughly $7 to $100 per month depending on the plan you choose.

If you have a Medigap policy (supplemental insurance), it covers some or all of the coinsurance and deductibles that Part B leaves you responsible for. Medigap premiums vary widely by plan and location, typically ranging from $100 to $300 per month, but they reduce your out-of-pocket costs significantly. If you have a Medicare Advantage plan instead, you pay a different structure — usually a lower or zero premium, but higher copays and coinsurance when you use services.

How to request a premium recalculation if your income changed

Contact Social Security at 1-800-772-1213 if your income dropped due to retirement, job loss, or divorce. Have your current tax return or a letter from your employer showing the income change ready. Social Security can recalculate your premium within one to three months and may refund overpayments you made while paying the higher rate.

You can also request a recalculation online through your My Social Security account at ssa.gov. Upload documentation of the income change — a W-2, 1099, or employer letter — and Social Security will review it. If approved, your new premium takes effect the month after Social Security processes the change.

Without a request, Medicare will use your prior-year income until the next automatic adjustment, which happens each January. If you wait until December to report a major income drop, you will have paid the higher premium for most of the year.

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 Medicaid or the Medicare Savings Program, which is run by your state. Contact your state Medicaid office to learn whether you meet the income limits.

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

If your premium is not deducted from Social Security and you do not pay by mail, Medicare will send you a notice. If you do not pay within 30 days, your coverage can be terminated. You can restart it, but you may face a permanent penalty on future premiums if you do not have a good reason for the gap.

Does Part B premium increase every year?

Yes, the standard premium typically increases each year based on inflation and program costs. In 2024 it is $164.90; in 2023 it was $164.90 as well, but prior years were lower. Medicare announces the new premium amount in October for the following year.

If I work past 65, do I still have to pay Part B?

If you are still covered by your employer's health plan and working, you can delay Part B without penalty. You must enroll within eight months of leaving your job or losing employer coverage to avoid the permanent penalty. Let Medicare know you have employer coverage so they do not charge you a penalty later.

Can I switch to a different Medicare plan to lower my costs?

You can switch from Original Medicare to a Medicare Advantage plan, or vice versa, during the annual enrollment period from October 15 to December 7. Different plans have different premiums and cost structures. Compare plans on Medicare.gov to see which one fits your budget and the doctors you use.