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

Your Medicare Part B premium — the monthly charge — depends on your income. Most people pay $164.90 per month in 2024, but if you earned more than $97,000 as a single filer in 2022, you pay a higher amount. The Social Security Administration adjusts these premiums every January based on the previous year's income, so your cost may change annually.

Beyond the premium, you also pay a $240 annual deductible before Medicare starts to cover most services. After you meet that deductible, you typically pay 20% of the cost for doctor visits, outpatient surgery, diagnostic tests, and other Part B services. Medicare pays the other 80%. These out-of-pocket costs have no yearly cap, which is why many people buy supplemental coverage or enroll in a Medicare Advantage plan.

Key Takeaways

  • The standard Part B premium is $164.90 per month in 2024, but rises to $217.80, $261.70, or higher if your 2022 income exceeded $97,000 as a single filer.
  • You pay a $240 annual deductible, then 20% of most doctor and outpatient services after that.
  • Part B does not cover routine dental, vision, or hearing care, so you may need separate plans or out-of-pocket payment for those.
  • If you delay enrolling in Part B when you first become may be able to access, you may face a permanent penalty of 10% per year of delay.

How Income Affects Your Part B Premium

Medicare uses your Modified Adjusted Gross Income (MAGI) from two years prior to set your premium. In 2024, the income thresholds are based on your 2022 tax return. If you filed as single and earned $97,000 or less, you pay the standard $164.90. If you earned between $97,001 and $123,000, you pay $205.80. The tiers continue upward, reaching $329.70 for income above $500,000.

Married couples filing jointly have higher thresholds — $194,000 to $243,000 for the second tier, for example. If your income has dropped since the year Medicare is using to calculate your premium, you can request a recalculation by contacting Social Security. You will need to show proof of the income change, such as a recent tax return or a letter from your employer.

What Part B Actually Covers and What It Does Not

Part B covers doctor office visits, lab work, X-rays, outpatient surgery, ambulance transport, and some preventive services like flu shots and cancer screenings. After you pay your deductible, Medicare covers 80% and you pay 20% for most of these services. Some preventive care — such as annual wellness visits and certain cancer screenings — is covered at 100% with no copay once you have met your deductible.

Part B does not cover dental cleanings, eyeglasses, hearing aids, or routine foot care. It also does not cover most physical therapy or mental health visits beyond a limited number per year without prior authorization. If you need these services, you either pay out of pocket or purchase a separate plan. Many people add a Medigap (supplemental) plan to cover the 20% coinsurance, or they choose a Medicare Advantage plan that may include dental and vision benefits.

The Difference Between Part B Premiums and Out-of-Pocket Costs

Your monthly premium is only one piece of your Part B cost. The deductible is what you pay before Medicare coverage kicks in each year. Once you meet it, you pay coinsurance — typically 20% of the Medicare-approved amount for each service. If a doctor charges more than Medicare allows, you may owe the difference as well, unless they accept Medicare assignment.

Unlike Part D (prescription drugs) or some Medicare Advantage plans, Part B has no annual out-of-pocket maximum. You could theoretically pay 20% of a very expensive surgery or ongoing treatment for the rest of the year with no cap. This is a major reason many people buy a Medigap plan, which covers the coinsurance and protects them from unlimited costs.

When Your Part B Premium Increases

Your premium can increase for two reasons: a general increase that affects everyone, or an income-related increase that affects only you. Social Security announces the general increase each October for the following year. In recent years, increases have ranged from 5% to 15%, though the amount varies based on Medicare's projected costs.

Income-related increases happen automatically if your income rises above the threshold for your filing status. You do not have to do anything — Medicare calculates it using your tax return. If you experience a major life event such as retirement, divorce, or death of a spouse, you can request that Medicare recalculate your premium using your current-year income instead of the prior-year figure. You must request this within 60 days of the event and provide documentation.

Part B Costs If You Delay Enrollment

If you do not enroll in Part B when you first become may be able to access at age 65, you will pay a permanent late enrollment penalty of 10% of the standard premium for each full year you delay. If you wait three years to enroll, you pay an extra 30% for life. The only exceptions are if you have employer coverage or you may have access to for a Special Enrollment Period due to loss of coverage.

This penalty applies even if you later switch to a different plan or if your income changes. It is one of the few Medicare penalties that never goes away, so most people enroll during their initial may be able to access period even if they do not use Part B services right away.

How to Estimate Your Total Part B Costs

To get a rough picture of your annual Part B expense, start with your monthly premium and multiply by 12. Then add the $240 deductible. For ongoing care, estimate how many doctor visits you expect and multiply by your 20% share of the Medicare-approved amount. Your doctor's office can tell you what Medicare allows for a specific service.

Keep in mind that this is an estimate. If you have a major health event — surgery, hospitalization, or a new chronic condition requiring frequent specialist visits — your out-of-pocket costs will be much higher. This is why many people compare the cost of adding a Medigap plan (which has its own monthly premium but covers coinsurance) against the risk of high out-of-pocket costs in a given year.

Frequently Asked Questions

Can I reduce my Part B premium if my income drops?

Yes. Contact Social Security if you experience a major life change such as retirement, loss of income, or death of a spouse. You can request that Medicare recalculate your premium using your current income instead of the prior-year figure. You must request this within 60 days of the event and provide proof, such as a recent tax return or a letter from your employer.

Do I have to pay Part B if I have employer coverage?

No. If you are still working and have health coverage through your employer or your spouse's employer, you can delay Part B enrollment without penalty. You must enroll within eight months of losing that coverage to avoid the late penalty. Keep documentation showing your employer coverage dates.

What happens if I cannot afford my Part B premium?

You may be able to get help paying your premium through Medicaid or a Medicare Savings Program, depending on your income and state. Contact your state Medicaid office or call 1-800-MEDICARE to learn what programs may be available in your area. Some programs cover the premium, deductible, and coinsurance.

Does Part B cover telehealth visits?

Yes. Medicare Part B covers telehealth visits with doctors and certain other providers, and you pay the same 20% coinsurance as you would for an in-person visit. Coverage expanded during the pandemic and many of those rules remain in place. Ask your doctor whether they offer telehealth appointments.

Will my Part B premium go up every year?

Most likely. Social Security adjusts the standard premium each January based on projected Medicare costs. The amount varies — some years it rises 5%, other years 10% or more. If your income increases, your income-related premium tier may also rise. Review your Social Security statement each year to see your new premium amount.