Medicare Part B costs you a monthly premium, an annual deductible, and coinsurance on most services

Medicare Part B covers doctor visits, outpatient care, and preventive services. You pay for it in three ways: a monthly premium taken from your Social Security check (or billed directly), a yearly deductible you must meet before Medicare starts to pay, and coinsurance—usually 20 percent of the cost—for most services after the deductible is met.

The monthly premium and annual deductible change each year. For 2024, the standard monthly premium is $174.70 for most people, and the annual deductible is $240. These amounts are set by Medicare and announced in the fall for the following year. If your income is higher than a certain threshold, you may pay a larger premium called an Income-Related Monthly Adjustment Amount (IRMAA).

Key Takeaways

  • The 2024 Part B monthly premium is $174.70 for most people, taken directly from your Social Security payment or billed to you.
  • The 2024 annual deductible is $240, which you pay out of pocket before Medicare begins to cover your doctor visits and outpatient services.
  • After you meet the deductible, you typically pay 20 percent coinsurance for most Part B services, and Medicare pays the rest.
  • If your income exceeds certain limits, you will pay a higher premium called IRMAA, which can be $50 to $560 more per month depending on your income level.
  • Preventive services like annual wellness visits, cancer screenings, and vaccinations are covered at no cost after you enroll in Part B.

How the deductible works in practice

The $240 annual deductible applies to most Part B services—doctor office visits, lab tests, X-rays, and outpatient hospital care. Once you have paid $240 out of pocket for covered services in a calendar year, the deductible is met. After that, Medicare pays its share (usually 80 percent) and you pay coinsurance (usually 20 percent) for the rest of the year.

The deductible resets on January 1 each year. If you see a doctor in December and pay $100 toward the deductible, that $100 does not carry over to the next year. You start fresh at $0 on January 1. Some services, like home health care and hospice, have different rules and do not count toward the Part B deductible.

Monthly premiums and income-based increases

The standard Part B premium of $174.70 per month (2024) is the amount most people pay. However, if your modified adjusted gross income (MAGI) from two years ago exceeds certain thresholds, Medicare charges you more. These higher amounts are called Income-Related Monthly Adjustment Amounts.

For example, if you filed taxes as a single person and your 2022 MAGI was over $97,000, you would pay more than the standard premium in 2024. The exact amount depends on your income bracket. The highest earners can pay up to $560.50 extra per month on top of the standard premium. If your income changes significantly—such as after retirement, a large withdrawal, or the death of a spouse—you can ask Medicare to recalculate your premium based on your current year's income.

What coinsurance means for your costs

Coinsurance is the percentage of the bill you pay after the deductible is met. For most Part B services, that percentage is 20 percent. If your doctor charges $200 for an office visit and Medicare approves $150, you would pay $30 (20 percent of $150) and Medicare would pay $120. However, if you have not yet met your $240 deductible, you would pay the full $150 until the deductible is satisfied.

Some services have different coinsurance amounts. Mental health services, for instance, may have different cost-sharing rules. Preventive services covered under Part B—such as annual wellness visits, mammograms, colonoscopies, and flu shots—are covered at no cost to you, meaning you pay nothing even before the deductible is met.

Preventive services that cost you nothing

Medicare Part B covers many preventive services at no charge, even before you meet your deductible. These include an annual wellness visit with your doctor, cancer screenings (mammogram, colorectal, prostate), bone density tests, cardiovascular screening, diabetes screening, and vaccines such as flu, pneumonia, and shingles shots.

To receive these services at no cost, you must see a doctor who accepts Medicare and who bills the service as preventive. If your doctor performs a preventive service and then finds a problem that requires additional testing or treatment, that follow-up care may be subject to the deductible and coinsurance. Ask your doctor beforehand if any additional services might be billed separately.

How to estimate your total Part B costs for the year

Your total Part B costs depend on how often you see doctors and what services you receive. Start by multiplying the monthly premium by 12 months: $174.70 × 12 = $2,096.40 for the standard premium in 2024. Add the annual deductible of $240. Then estimate your coinsurance based on the services you expect to use.

If you have chronic conditions and see specialists regularly, your coinsurance costs will be higher. If you rarely see a doctor, you may only pay the premium and deductible. Many people also carry a Medigap (supplemental insurance) or Medicare Advantage plan to help cover the deductible and coinsurance, which reduces their out-of-pocket costs but adds another monthly premium.

When costs change and how to stay informed

Medicare announces new premiums and deductibles in October for the following year. You will receive a notice in the mail explaining any changes to your premium. If you receive Social Security, the new premium is usually deducted starting in January. If you do not receive Social Security, you will be billed directly by Medicare.

You can check your current premium and deductible on the official Medicare website (Medicare.gov) or by calling 1-800-MEDICARE. If you believe your premium is incorrect or if your income has changed significantly, you can request a recalculation. Keep records of your out-of-pocket costs throughout the year so you know when you have met your deductible.

Frequently Asked Questions

Does the Part B deductible reset every year?

Yes. The deductible resets on January 1 each year. Any amount you paid toward the deductible in December does not carry over to January. You start at $0 and must pay the full deductible amount again in the new year.

What happens if my doctor charges more than Medicare approves?

If your doctor is a Medicare participating provider, they have agreed to accept Medicare's approved amount as payment in full. You pay only your share of the approved amount. If your doctor is a non-participating provider, they may charge up to 15 percent more than the approved amount, and you are responsible for that extra charge.

Can I reduce my Part B costs with other insurance?

Yes. A Medigap policy or Medicare Advantage plan can help pay your deductible and coinsurance. Medigap is supplemental insurance sold by private companies. Medicare Advantage is an alternative to Original Medicare offered by private insurers. Both have their own costs and coverage rules, so compare them carefully.

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

If you are still working and covered by your employer's health plan, you may be able to delay enrolling in Part B without penalty. However, once you enroll, you must pay the premium and deductible like anyone else. Talk to your employer's benefits office about how your coverage works with Medicare.

What if I cannot afford my Part B premium?

If your income is low, you may be able to get help paying your Part B premium through your state's Medicare Savings Program. These programs are run by each state and help pay premiums, deductibles, and coinsurance for people who meet income limits. Contact your state Medicaid office or call 1-800-MEDICARE for information about programs in your state.