Medicare Part B premiums and out-of-pocket costs
Medicare Part B covers doctor visits, outpatient care, and medical equipment. The monthly premium you pay depends on your income — most people pay one amount, but if you earn above a certain threshold, you pay more. For 2024, the standard premium is $164.90 per month, but yours may be higher or lower based on your tax return from two years ago.
Beyond the premium, you also pay a yearly deductible (the amount you must spend before Medicare starts paying) and coinsurance (your percentage of the cost after the deductible is met). For 2024, the Part B deductible is $240 per year. After you meet it, Medicare typically pays 80 percent of covered services, and you pay 20 percent.
These costs change each year. The Centers for Medicare & Medicaid Services (CMS) announces new premiums and deductibles in the fall, and they take effect January 1. If you are already on Medicare, you will receive a notice in the mail showing your new premium.
Key Takeaways
- The standard Medicare Part B premium for 2024 is $164.90 per month, but your actual premium depends on your income from two years prior.
- You pay a yearly deductible of $240 (2024) before Medicare begins to cover services, then you typically pay 20 percent coinsurance for most services.
- If your income is above certain thresholds, you will pay a higher premium through a process called Income-Related Monthly Adjustment Amount (IRMAA).
- Premiums and deductibles increase each year; CMS announces changes in the fall for the following January.
- You can reduce out-of-pocket costs by choosing in-network providers, enrolling in a Medigap or Medicare Advantage plan, or both.
How income affects your Part B premium
If your modified adjusted gross income (MAGI) from your tax return exceeds a certain amount, Medicare charges you a higher premium through something called Income-Related Monthly Adjustment Amount (IRMAA). The income thresholds are the same for everyone, but they change yearly. For 2024, if you are single and your MAGI is above $97,000, you will pay more than the standard premium.
The brackets go up in steps. A single person with MAGI between $97,001 and $121,000 pays about $230 per month instead of $164.90. Someone with MAGI above $500,000 pays roughly $560 per month. Married couples filing jointly have higher thresholds — the first bracket starts at $194,000 MAGI.
Medicare uses your tax return from two years before the current year. So in 2024, they look at your 2022 return. If your income dropped significantly in 2023 or 2024 — because you retired, had a major life change, or lost income — you can request that Medicare use your current year's income instead. You do this by calling Social Security at 1-800-772-1213 and asking about a life-changing event appeal.
What Part B covers and what it does not
Part B pays for doctor office visits, preventive care (like annual wellness exams and cancer screenings), lab tests, X-rays, and durable medical equipment such as wheelchairs and oxygen. It also covers outpatient surgery, mental health services, and physical therapy. Most of these services require you to pay the deductible and then 20 percent coinsurance.
Part B does not cover routine dental work, eye exams for glasses, hearing aids, or long-term care in a nursing home. 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.
Medigap and Medicare Advantage: ways to lower costs
Many people buy a Medigap policy (also called Medigap insurance) to cover the deductible and coinsurance that Part B leaves you responsible for. Medigap is sold by private insurance companies and costs extra, but it can significantly reduce your out-of-pocket spending. For example, a Medigap Plan G covers the Part B deductible and your 20 percent coinsurance, so you pay little or nothing at the doctor's office.
Alternatively, you can enroll in a Medicare Advantage plan (Part C), which is an all-in-one alternative to Original Medicare. Medicare Advantage plans are run by private insurers and often have lower or zero premiums, but they typically have copays and coinsurance instead of the 20 percent coinsurance model. They also usually require you to use doctors in their network.
You can enroll in Medigap during your initial enrollment period (the six months starting when you turn 65 and enroll in Part B) or during the annual open enrollment period in the fall. Medicare Advantage has its own enrollment windows. If you miss these windows, you may face waiting periods or higher premiums.
When and how to pay your Part B premium
If you are already receiving Social Security, your Part B premium is usually deducted automatically from your monthly benefit. You will see the amount on your Social Security statement each month. If you are not yet on Social Security, Medicare will bill you directly by mail or, if you set it up, by automatic bank withdrawal.
You can change how you pay by contacting Medicare at 1-800-MEDICARE (1-800-633-4227) or visiting Medicare.gov. If you miss a payment, Medicare will send you a notice. If you do not pay within three months, your Part B coverage can be terminated, and you will face a penalty if you enroll later.
Income thresholds and IRMAA brackets for 2024
| Filing Status | Income Range | Monthly Premium |
|---|---|---|
| Single | Up to $97,000 | $164.90 |
| Single | $97,001–$121,000 | $230.00 |
| Single | $121,001–$145,000 | $295.10 |
| Single | $145,001–$169,000 | $360.20 |
| Single | Over $169,000 | $560.50 |
| Married Filing Jointly | Up to $194,000 | $164.90 |
| Married Filing Jointly | $194,001–$242,000 | $230.00 |
| Married Filing Jointly | Over $242,000 | $560.50 |
These amounts are for 2024 and will change in 2025. The income thresholds and premium amounts are set by CMS each fall. If your income is close to a threshold, keep in mind that Medicare looks back two years, so a major income change in the current year will not affect your premium until two years later.
Questions to ask your doctor or Medicare
Before you have a procedure or test, ask your doctor whether it is covered by Part B and whether they accept Medicare. Ask whether the service will be done in an office (covered) or a hospital outpatient department (sometimes covered differently). If you are considering Medigap or Medicare Advantage, ask your doctor which plans they accept — not all doctors participate in all plans.
If you receive a bill you think is wrong, call the phone number on the bill or contact Medicare directly. You have the right to ask for an explanation of benefits (EOB), which shows what Medicare paid and what you owe.
Frequently Asked Questions
Can I change my Part B coverage if my income drops?
Yes. If you experience a major life change such as retirement, job loss, or divorce, you can request that Medicare use your current year's income instead of the income from two years ago. Call Social Security at 1-800-772-1213 and explain the change. You will need to provide documentation such as a recent tax return or a letter from your employer.
What happens if I do not enroll in Part B when I first become may be able to access?
If you delay Part B without a valid reason, you will pay a penalty for as long as you have Medicare. The penalty is 10 percent of the standard premium for each full year you were not enrolled. For example, if you delay for three years, you will pay 30 percent more than the standard premium permanently.
Does Part B cover telehealth visits?
Yes. Medicare Part B covers telehealth visits with doctors and other providers, and you pay the same deductible and coinsurance as you would for an in-person visit. However, not all providers offer telehealth, and some services (such as physical exams) still require an in-person appointment.
If I have a Medigap plan, do I still pay the Part B premium?
Yes. You pay both your Part B premium to Medicare and your Medigap premium to the private insurance company. Medigap covers the costs that Part B does not — the deductible and coinsurance — but it does not replace your Part B premium.
What is the difference between Part B coinsurance and a copay?
Coinsurance is a percentage of the cost (usually 20 percent with Part B). A copay is a fixed dollar amount you pay per visit. Medicare Advantage plans often use copays, while Original Medicare Part B uses coinsurance. Medigap can cover either one, depending on the plan.