Part B premiums change every year, and what you pay depends on your income

Part B is the portion of Medicare that covers doctor visits, outpatient care, and medical equipment. The standard monthly premium for 2024 is $164.90, but you may pay more or less depending on your income from two years ago. If you earned more than a certain threshold, Medicare charges you a higher amount called an Income-Related Monthly Adjustment Amount (IRMAA). If you're on a tight budget, you may also be able to get help paying your Part B costs through Medicaid or other programs.

The income threshold used is always from two years before the current year. This means your 2024 premium is based on your 2022 income. Your 2025 premium will be based on your 2023 income. Medicare sends you a notice each fall showing what you'll pay the following year, and you have the right to challenge that amount if your circumstances have changed.

Key Takeaways

  • The standard Part B premium for 2024 is $164.90 per month, but higher earners pay more based on income from two years prior.
  • Income thresholds that trigger higher premiums start at $97,000 for single filers and $194,000 for married couples filing jointly.
  • You can appeal an IRMAA increase if your income dropped due to retirement, job loss, or divorce in the current year.
  • Medicaid, the Medicare Savings Program, and other state programs can help pay your Part B premium if your income is low enough.
  • Part B premiums are deducted from your Social Security check each month, or you receive a bill if you're not yet collecting Social Security.

The standard premium and income-based increases

For 2024, most people on Medicare Part B pay $164.90 per month. This is the standard premium, and it covers the basic cost of the program. However, if your modified adjusted gross income (MAGI) from 2022 was above a certain level, you pay more.

Medicare uses a sliding scale with five income brackets. Single filers who earned more than $97,000 in 2022 pay a higher premium. Married couples filing jointly who earned more than $194,000 pay more. The highest earners can pay up to $560.50 per month for Part B in 2024. The exact amount depends on which bracket your income falls into. You can find your specific bracket on the Medicare.gov website or by calling Social Security at 1-800-772-1213.

When and how you pay your Part B premium

If you receive Social Security benefits, your Part B premium is subtracted automatically from your monthly check. You do not receive a separate bill. The amount appears on your Social Security payment stub.

If you are not yet receiving Social Security, or if you have other Medicare coverage, you receive a bill from Medicare each month. The bill arrives by mail or email, depending on how you set up your account. You can pay by check, automatic bank withdrawal, or credit card. Payments are due by the 30th of the month for coverage that month.

If you miss a payment, Medicare may disenroll you from Part B. You can re-enroll during the General Enrollment Period (January 1 to March 31 each year), but you may face a permanent penalty of 10 percent added to your premium for each year you were not enrolled.

How to appeal an income-based premium increase

If your income dropped significantly in the current year due to retirement, job loss, divorce, or death of a spouse, you can ask Medicare to use your current-year income instead of the prior-year income. This is called a Life-Changing Event appeal. You must file the appeal within 60 days of the event that caused your income to drop. If you miss this window, you cannot appeal until the next calendar year.

To file an appeal, contact Social Security at 1-800-772-1213 or visit your local Social Security office. You will need to provide proof of the event — such as a termination letter, divorce decree, or death certificate — and documentation of your new income, such as a recent pay stub or tax return. Social Security will review your request and send you a new decision letter within 30 days. If approved, your new premium takes effect the following month.

Programs that help pay your Part B premium

If your income is low, you may be able to get help paying your Part B premium through Medicaid or the Medicare Savings Program (MSP). These are state-run programs, so the income limits and rules vary by state.

The Medicare Savings Program has three tiers. The may have access to Medicare Beneficiary (QMB) program pays your Part B premium, deductible, and coinsurance if you meet the income limit. The Specified Low-Income Medicare Beneficiary (SLMB) program pays only your Part B premium. The may have access to Individual (QI) program also pays your Part B premium but has a slightly higher income limit. To find out which program you may be able to use, contact your state Medicaid office or call 1-800-MEDICARE.

You can also check whether you may have access to for Extra Help, a federal program that helps with prescription drug costs. Extra Help does not pay your Part B premium directly, but it can free up money in your budget by reducing what you pay for medications.

What happens if you delay Part B enrollment

If you are not yet 65 and not yet on Medicare, you do not have to enroll in Part B right away. However, if you delay enrollment after you become may be able to access, you may face a permanent penalty. The penalty is 10 percent of the standard premium for each full year you were not enrolled. This penalty stays with you for life.

There are exceptions. If you are still working and covered by your employer's health plan, you may be able to delay Part B without penalty. You must have creditable coverage through your employer or your spouse's employer. When you leave that job or lose that coverage, you have eight months to enroll in Part B without penalty. This is called the Special Enrollment Period.

How Part B premiums are expected to change

Part B premiums increase each year based on the cost of medical services and the number of people on Medicare. The Centers for Medicare and Medicaid Services (CMS) announces the new premium amount in the fall, and it takes effect on January 1. Premiums have risen most years, though the amount of increase varies.

Income thresholds for IRMAA also adjust each year. These thresholds are tied to inflation, so they may increase slightly year to year. You can check the current year's thresholds on Medicare.gov or by calling Social Security. When you receive your annual notice from Medicare in the fall, it will show both the new standard premium and any change to your income-based amount.

Frequently Asked Questions

Can I reduce my Part B premium if my income dropped this year?

Yes, if your income fell due to retirement, job loss, divorce, or death of a spouse, you can file a Life-Changing Event appeal with Social Security within 60 days of the event. You will need to provide proof of the event and your new income. If approved, your premium will be recalculated based on your current-year income.

What if I don't enroll in Part B when I first become may be able to access?

You will face a permanent 10 percent penalty on your Part B premium for each full year you delay. The only exception is if you have credible coverage through an employer. If you lose that coverage, you have eight months to enroll without penalty.

Do I have to pay Part B if I'm still working?

Yes, you must pay Part B if you are enrolled, even if you are still working and have employer coverage. However, you may be able to delay enrolling in Part B without penalty if your employer plan is credible coverage. Talk to your employer's benefits office about your options.

How do I know if I may have access to for help paying my Part B premium?

Contact your state Medicaid office or call 1-800-MEDICARE to learn about the Medicare Savings Program and other information programs in your state. Income limits vary by state, and the programs have different rules about what they cover.

Will my Part B premium go up next year?

Part B premiums typically increase each year, though the amount varies. CMS announces the new premium in the fall for the following year. You can check Medicare.gov or call Social Security to find out the projected premium for the coming year.