Medicare Part B costs you a monthly premium, and the amount depends on your income

Your Medicare Part B premium is the monthly fee you pay to have coverage for doctor visits, outpatient care, and other services Part B covers. In 2024, the standard premium is $164.90 per month for most people, but you may pay more or less depending on your income from two years ago. If you're on Social Security, the premium is usually taken directly from your monthly benefit.

The premium amount changes each year. Medicare announces the new rate in the fall, and it takes effect January 1. Your actual premium can be higher than the standard amount if your income was above a certain threshold in the prior year — a rule called Income-Related Monthly Adjustment Amount (IRMAA). You may also pay less if you may have access to for help through a state or federal program.

Key Takeaways

  • The standard Part B premium for 2024 is $164.90 per month, but your actual premium depends on your income from two years prior.
  • If your income exceeds certain thresholds, you will pay a higher premium through IRMAA surcharges that can range from about $66 to $560 more per month.
  • You can find your exact premium amount on your Medicare card, in your welcome letter, or by calling Medicare at 1-800-MEDICARE.
  • If you cannot afford the premium, you may be able to get help through Medicaid, the Medicare Savings Program, or other state information programs.

How the standard premium is set each year

Medicare calculates the Part B premium based on the expected cost of providing Part B services to all beneficiaries in the coming year. The amount is set so that beneficiaries pay roughly 25 percent of the total cost, and the federal government covers the remaining 75 percent through general tax revenue.

Because medical costs change year to year, the premium changes too. In recent years, the premium has ranged from about $144 to $175 per month. The Centers for Medicare & Medicaid Services (CMS) announces the new premium amount each October for the following year. If you're already on Medicare, you'll receive a notice in the mail showing your 2025 premium by December 1, 2024.

Income-related surcharges (IRMAA) and higher premiums

If your modified adjusted gross income (MAGI) from two years ago exceeds a certain amount, you pay a surcharge on top of the standard premium. For 2024, the income thresholds are $97,000 for single filers and $194,000 for married couples filing jointly. If you're above these amounts, your premium increases in steps.

The surcharge can add anywhere from roughly $66 to $560 per month to your standard premium, depending on how much your income exceeds the threshold. For example, a single person with income between $97,001 and $123,000 in 2022 would pay an extra $66 per month in 2024. Someone with income over $500,000 would pay the maximum surcharge. These thresholds and amounts change each year, so check your notice to see your exact surcharge.

The surcharge applies to all three parts of Original Medicare that have premiums: Part B, Part D (prescription drugs), and Part A (hospital insurance, though most people don't pay a Part A premium). If you have a Medicare Advantage plan or a Medigap policy, you still pay the Part B surcharge separately.

When you can pay less than the standard premium

If your income is low, you may not have to pay the full Part B premium. The Medicare Savings Program (MSP) helps people with limited income and resources pay their Part B premiums, deductibles, and copayments. Each state runs its own program with slightly different income limits, but generally you may have access to if your income is between 100 and 200 percent of the federal poverty level.

You can also get help through Medicaid if you meet your state's income and asset limits. Some people are enrolled in both Medicare and Medicaid (called "dual may be able to access"). If you're dual may be able to access, Medicaid usually pays your Part B premium automatically.

To find out whether you may have access to for the Medicare Savings Program in your state, contact your state Medicaid office or call 1-800-MEDICARE. You can also visit the Medicare website and search for your state's program. The process process varies by state but usually involves submitting proof of income and citizenship.

How to find your exact premium amount

Your Part B premium is printed on your Medicare card and in any notice Medicare sends you. If you're on Social Security, your benefit statement also shows the amount being deducted. You can also log into your Medicare account at Medicare.gov, call 1-800-MEDICARE, or visit a local Social Security office.

If you receive a notice showing a premium increase and you believe it's wrong — for example, because your income dropped due to retirement or a major life event — you can request a review. This is called an appeal of the IRMAA information. You have 60 days from the date on the notice to request one. You'll need to provide documentation of the life event, such as a divorce decree, death certificate, or letter from your employer showing a job loss.

What happens if you don't pay your premium

If you don't pay your Part B premium, your coverage will be terminated. Once terminated, you cannot re-enroll in Part B until the next General Enrollment Period (January 1 to March 31 each year), and you may face a permanent late-enrollment penalty of 10 percent added to your premium for each full year you were without coverage.

If you're having trouble paying, contact Medicare before your coverage ends. You may be able to set up a payment plan or find out about programs that can help. If you're on Social Security and your benefits are too low to cover the premium, you may be able to get help through the Medicare Savings Program or Medicaid.

Part B premium versus other Medicare costs

The Part B premium is only one part of what you pay for Medicare. You also pay an annual deductible ($240 in 2024) before Part B coverage begins, and then you pay 20 percent of the cost of most services after that. If you see a doctor who doesn't accept Medicare assignment, you may pay more. Some services, like preventive care, have no copayment or coinsurance.

If you want to limit your out-of-pocket costs beyond the premium, you can enroll in a Medigap policy (also called supplemental insurance) or a Medicare Advantage plan. Medigap policies help pay your deductibles and copayments but have their own monthly premiums. Medicare Advantage plans often have lower or no premiums but may have higher copayments and require you to use in-network providers. Both are separate from your Part B premium.

Frequently Asked Questions

Will my Part B premium go up every year?

The standard premium usually increases each year because medical costs rise, but the amount of the increase varies. Some years the increase is small; other years it's larger. Your personal premium may also change if your income changes, which affects your IRMAA surcharge.

What if I'm still working and have employer health insurance?

If you're covered by an employer plan, you may be able to delay enrolling in Part B without a penalty, as long as you enroll within eight months of losing that coverage. During the time you're covered by your employer, you still pay the Part B premium if you're enrolled, but you may not need to use Part B benefits. Talk to your employer's benefits office about your options.

Can I get my Part B premium back if I don't use Medicare?

No, the premium is not refundable. You pay it whether you use Part B services or not. However, if you enrolled in Part B by mistake or during a period when you had other coverage, you may be able to disenroll and avoid future premiums. Contact Medicare to discuss your situation.

How do I know if my IRMAA surcharge is correct?

Medicare uses your tax return from two years prior to calculate IRMAA. If your income has changed significantly since then — such as from a job loss, retirement, or major life event — you can request a review. You'll need to provide documentation and file the request within 60 days of receiving your notice.

What income counts toward the IRMAA threshold?

IRMAA is based on your modified adjusted gross income (MAGI), which includes wages, interest, dividends, and certain other income reported on your tax return. It does not include Social Security benefits unless you file a joint return with a non-citizen spouse. If you're unsure whether your income counts, ask Medicare when you request your IRMAA review.