Medicare Part B costs you a monthly premium, an annual deductible, and a percentage of most doctor visits and services

Medicare Part B covers doctor visits, outpatient care, lab tests, and medical equipment. You pay for it in three ways: a monthly premium taken from your Social Security check, an annual deductible you meet before coverage kicks in, and coinsurance (usually 20 percent) on most services after that.

The exact amounts change each year. For 2024, the standard monthly premium is $164.90, the annual deductible is $240, and you typically pay 20 percent of the Medicare-approved cost for doctor visits and outpatient services. However, your premium may be higher if your income was above a certain level two years ago — Medicare uses a process called Income-Related Monthly Adjustment Amount (IRMAA) to raise premiums for higher earners.

If you delay signing up for Part B when you first become may be able to access at 65, you will owe a permanent penalty of 10 percent for each year you waited. That penalty stays on your premium for life, so timing matters.

Key Takeaways

  • The 2024 Part B premium is $164.90 per month for most people, but yours may be higher if your income exceeds certain thresholds.
  • You pay a $240 annual deductible in 2024, then 20 percent coinsurance on most doctor visits and outpatient services.
  • If you delay Part B enrollment past 65 without a valid reason, you face a permanent 10 percent penalty on your premium for each year you waited.
  • Part B premiums and deductibles increase most years, so your 2025 costs will likely be different from 2024.

How the monthly premium works

Your Part B premium is deducted automatically from your Social Security payment each month. If you are not yet receiving Social Security, Medicare bills you directly. The standard amount for 2024 is $164.90, but you may pay more if your modified adjusted gross income (MAGI) from two years prior was above $97,000 for a single filer or $194,000 for a married couple filing jointly.

Income brackets for the premium surcharge are set by Medicare each year. If your income falls into a higher bracket, you will see a separate line item on your Medicare bill called an IRMAA. For example, a single person with a MAGI between $97,001 and $123,000 pays an extra $66 per month on top of the standard premium in 2024. The surcharge grows larger at higher income levels and can add $77, $99, $120, or more per month depending on your income tier.

You can request a review of your IRMAA if your income dropped significantly in the current year — for instance, because you retired or had a major life change. You will need to submit a form and documentation of the change to Medicare.

The annual deductible and coinsurance

Before Medicare Part B starts paying its share, you must meet an annual deductible. In 2024, that deductible is $240. Once you have paid $240 out of pocket for covered services, Medicare begins to cover 80 percent of the Medicare-approved amount for most services, and you pay the remaining 20 percent (called coinsurance).

The deductible resets on January 1 each year. Some services, like preventive care visits and screenings, do not count toward the deductible and are covered at 100 percent with no coinsurance. These include annual wellness visits, cancer screenings, and certain vaccinations.

Coinsurance is calculated on the Medicare-approved amount, not what a provider actually charges. If a doctor charges $500 but Medicare's approved amount is $300, you pay 20 percent of $300 ($60), not $100. This is why seeing in-network providers and understanding what Medicare approves matters for your out-of-pocket costs.

What Part B does and does not cover

Part B covers doctor office visits, emergency room care, outpatient surgery, lab tests, X-rays, physical therapy, and durable medical equipment like wheelchairs and oxygen. It also covers mental health services, including therapy and psychiatry visits. Preventive services — such as colonoscopies, mammograms, and flu shots — are covered at no cost to you once you meet your deductible (or with no deductible at all for certain preventive visits).

Part B does not cover routine dental care, vision exams for glasses or contacts, hearing aids, or long-term care in a nursing home or at home. It also does not cover most prescription drugs — that is what Part D is for. If you need these services, you may want to consider a Medigap or Medicare Advantage plan to fill the gaps.

How Medicare Advantage and Medigap affect your Part B costs

If you choose a Medicare Advantage plan (Part C), you still pay your Part B premium, but the plan replaces Original Medicare and typically has lower copays and coinsurance. However, Advantage plans often have network restrictions and may require prior authorization for certain services. Your out-of-pocket maximum is capped, which can protect you from very high costs in a given year.

If you stay on Original Medicare (Part A and Part B), you can buy a Medigap policy to cover some or all of the coinsurance and deductible you would otherwise pay. Medigap plans are sold by private insurers and have their own monthly premiums, but they can reduce your out-of-pocket costs significantly. The trade-off is that you pay both your Part B premium and a Medigap premium.

Neither Advantage nor Medigap covers everything, so compare what each plan covers and what you would pay in premiums and out-of-pocket costs for the services you use most.

When Part B costs increase and how to plan ahead

Medicare announces new Part B premiums, deductibles, and coinsurance amounts each October for the following year. Premiums have risen most years, though the amount varies. Your 2025 premium and deductible will be different from 2024, and you should expect them to change again in 2026.

If you are still working and covered by an employer health plan, you may be able to delay Part B enrollment without penalty. This is called creditable coverage. Once you leave that job or lose the coverage, you have eight months to sign up for Part B without penalty. If you miss that window, the 10 percent annual penalty applies for as long as you have Part B.

To stay informed, check your Medicare Summary Notice (the bill you receive each year) and review your coverage during the annual open enrollment period in October and November. This is when you can switch plans or adjust your coverage for the coming year.

Frequently Asked Questions

Can I get Part B for free?

No. Part B always has a monthly premium, an annual deductible, and coinsurance. However, if your income is very low, you may be able to get help paying your premiums through Medicaid or the Medicare Savings Programs, which are run by your state. Contact your state Medicaid office to learn whether you may be may be able to access.

What happens if I can't afford my Part B premium?

If you cannot afford the standard premium, look into the Medicare Savings Programs (MSP) offered by your state. These programs can pay your Part B premium, deductible, and coinsurance if you meet income and asset limits. Income limits vary by state, so contact your state Medicaid office or call 1-800-MEDICARE to find out what your state offers.

Does Part B cover doctor visits when I travel outside the United States?

Original Medicare Part B does not cover routine care outside the U.S., except in very limited situations (like emergency care in Canada or Mexico near the border). If you travel internationally, consider a travel health insurance plan or a Medicare Advantage plan that covers out-of-country care. Check your plan's rules before you leave.

If I have both Medicare and an employer health plan, do I still pay Part B?

Yes. You pay your Part B premium even if you have employer coverage. However, if your employer plan is primary (pays first), Medicare becomes secondary and may pay less. Coordinate your benefits carefully, and tell your doctor's office about both plans so they bill correctly.

Why is my Part B premium higher than my neighbor's?

Your premium is likely higher because of IRMAA — an income-based surcharge. If your income two years ago was above the threshold, Medicare adds extra to your premium. Your neighbor may have lower income, or they may have requested an IRMAA review if their income dropped. You can request a review too if your circumstances changed.