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

The Part B premium for 2024 is $174.70 per month for most people. However, if your income is higher, you will pay more — Medicare charges higher premiums based on your modified adjusted gross income from two years prior. If you earned more in 2022, your 2024 premium will reflect that.

Beyond the monthly premium, 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% of the cost for most services — Medicare pays the other 80%. For some services like lab work, you pay nothing once the deductible is met.

These amounts change each year. The premium and deductible are set by the federal government and announced in the fall for the following year. If you are already on Medicare, you will receive a notice in October or November telling you the new amounts.

Key Takeaways

  • The standard Part B premium is $174.70 monthly in 2024, but you pay more if your income from two years ago was above certain thresholds.
  • You also owe a $240 annual deductible before Medicare covers most doctor and outpatient services.
  • After meeting the deductible, you typically pay 20% of the cost for covered services while Medicare covers 80%.
  • Premium and deductible amounts increase most years; check your notice in the fall to learn what you will pay the following year.
  • If you cannot afford the premium, you may be able to get help paying it through your state's Medicaid program or a Medicare Savings Account.

How income affects your Part B premium

If your modified adjusted gross income (MAGI) was above $97,000 as a single filer or $194,000 as a married couple filing jointly in 2022, you pay a higher premium in 2024. The higher you earned, the more you pay — there are five income brackets, and the premium can be as high as $560.50 per month for the highest earners.

Medicare uses your tax return from two years prior because that is the most recent complete tax information available. If your income dropped significantly — you retired, had a major loss, or your spouse died — you can ask Medicare to use your current year's income instead. You will need to file a form called the Income Related Monthly Adjustment Amount (IRMAA) appeal and provide proof of the change, such as a recent tax return, a letter from your employer, or a death certificate.

You have 60 days from the date on your premium notice to file an appeal. If you miss that window, you can still appeal, but it is harder. Contact Social Security or Medicare directly to ask about your specific situation.

What Part B actually covers and what you pay

Part B covers doctor visits, outpatient hospital services, medical equipment, and preventive care. Once you meet your $240 deductible, you pay 20% of the Medicare-approved amount for most services. For example, if a doctor visit costs $150 and Medicare approves $120, you pay 20% of $120, which is $24.

Some services have different cost-sharing rules. Preventive services like annual wellness visits, cancer screenings, and vaccinations are covered at no cost once you are enrolled in Part B — you do not pay the 20% copayment. Lab work and imaging ordered by your doctor are also covered at no cost after the deductible.

If you see a doctor who does not accept Medicare (called an "out-of-network" provider), you may pay more. Some doctors do not accept Medicare at all, and you would be responsible for the full bill. Before scheduling an appointment, ask the office whether they accept Medicare and whether they are "accepting new Medicare patients."

When Part B premiums are deducted from your benefits

If you receive Social Security, your Part B premium is automatically deducted from your monthly check. This happens whether you signed up for Part B when you first became may be able to access or whether you enrolled later. The deduction appears as a line item on your Social Security statement.

If you do not receive Social Security — for example, you are still working or you have not yet started claiming benefits — Medicare sends you a bill each month. You can pay by mail, phone, or online through the Medicare website. If you miss a payment, Medicare will send you a notice and may eventually disenroll you from Part B, which can trigger a late-enrollment penalty if you sign up again later.

If you are having trouble paying your premium, tell Medicare or Social Security right away. Waiting until you are months behind makes it harder to catch up and can result in a gap in your coverage.

Getting help paying your Part B premium

If your income is low, your state's Medicaid program may pay your Part B premium for you. This is called a Medicare Savings Account, and it covers the premium, deductible, and copayments. Each state runs its own program and sets its own income limits, so what qualifies in one state may not in another.

To learn whether you may have access to, contact your state Medicaid office or call 1-800-MEDICARE. You can also visit your local Area Agency on Aging, which can help you figure out whether you are may be able to access and how the process works. These agencies do not charge a fee.

Some people also may have access to for Extra Help, a federal program that helps pay for prescription drug costs under Part D. If you may have access to for Extra Help, you may also may have access to for a Medicare Savings Account. The two programs work together.

Part B costs compared to other Medicare coverage options

If you choose Original Medicare (Part A and Part B), you pay the monthly premium, the annual deductible, and 20% copayments. You can see any doctor who accepts Medicare, and you have broad coverage for hospital stays and outpatient services.

If you choose a Medicare Advantage plan (Part C), you typically pay a lower or zero monthly premium, but you have a network of doctors and hospitals you must use (except in emergencies). You also pay copayments, which are often a fixed dollar amount rather than a percentage. Some Medicare Advantage plans cover dental, vision, or hearing — Original Medicare does not.

The trade-off is flexibility versus lower out-of-pocket costs. Original Medicare costs more upfront but gives you more choice. Medicare Advantage costs less upfront but limits where you can go. Your choice depends on your health, your doctors, and your budget.

Frequently Asked Questions

Do I have to pay Part B if I am still working?

Yes, if you are enrolled in Part B, you pay the premium whether you are working or retired. However, if you are still working and have health insurance through your employer, you may be able to delay enrolling in Part B without a penalty. Talk to your employer's benefits office about whether you should stay on their plan or switch to Medicare.

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

If you miss payments, Medicare will send you a notice. If you do not pay within a certain period, Medicare can disenroll you from Part B. If you sign up again later, you may owe a late-enrollment penalty — an extra 10% added to your premium for each year you were not enrolled. The penalty is permanent.

Can my Part B premium go down?

Your premium can go down if your income drops significantly. If you retired, lost a job, or had a major life change, you can file an IRMAA appeal and ask Medicare to use your current income instead of your income from two years ago. You must file within 60 days of receiving your premium notice.

Does Part B cover dental, vision, or hearing?

Original Medicare Part B does not cover routine dental, vision, or hearing care. You can buy a separate dental or vision plan, or you can choose a Medicare Advantage plan that includes these benefits. Some plans cover preventive services like one eye exam per year, but coverage varies widely.

What if I cannot afford the $240 deductible?

If your income is low, a Medicare Savings Account through your state Medicaid program will pay your deductible. You can also ask your doctor's office about payment plans or sliding-scale fees. Some community health centers offer services on a sliding-scale basis based on your income.