Medicare Part B costs you a monthly premium, an annual deductible, and a share of each doctor visit or service

Your 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 that can reach $560.50 per month. Medicare uses your tax return from two years back to set this, so your 2024 premium is based on 2022 income.

On top of the premium, you pay a $240 annual deductible before Medicare starts to cover most services. After you meet that deductible, you typically pay 20 percent of the cost for doctor visits, lab work, imaging, and outpatient hospital care. There is no monthly cap on these out-of-pocket costs under Part B alone, which is why many people add a Medigap or Medicare Advantage plan to limit their spending.

The exact amounts change each year. The Centers for Medicare & Medicaid Services (CMS) announces the new premiums and deductible in the fall, usually in October, for the following January. If you are already on Medicare, you will receive a notice in the mail showing your specific premium for the next year.

Key Takeaways

  • The standard Part B premium in 2024 is $164.90 per month, but rises to $560.50 if your income was above $97,000 as a single filer in 2022.
  • You pay a $240 annual deductible, then 20 percent coinsurance for most services, with no upper limit unless you have additional coverage.
  • Medicare uses your income from two years prior to set your premium, so changes in your earnings take time to show up in your bill.
  • Premiums and deductibles increase most years; CMS announces the new amounts each October for the following year.
  • If you cannot afford Part B premiums, Medicaid in your state may pay them for you, and you can ask about this when you enroll.

How income affects your Part B premium

Medicare uses a sliding scale called Income-Related Monthly Adjustment Amount (IRMAA) to set your premium if you earned above a certain threshold. For 2024, the income brackets are based on your Modified Adjusted Gross Income (MAGI) from your 2022 tax return. If you filed jointly and your MAGI was $194,000 or less, you pay the standard premium. Above that, your premium rises in steps.

The highest earners — those with MAGI above $500,000 as a joint filer — pay $560.50 per month in 2024. This is more than three times the standard rate. If your income drops in the current year, you can request that Medicare recalculate your premium using your current-year income instead. You will need to file a form called the Medicare Income-Related Monthly Adjustment Amount — Life-Changing Event (form SSA-44) and provide proof of the income change, such as a recent tax return or a letter from your employer showing a job loss.

The income thresholds and premium amounts change each year. In 2023, for example, the standard premium was $164.90 (the same as 2024), but the income brackets were slightly different. Always check your notice from Social Security or Medicare to see what you will pay.

What Part B actually covers and what you pay

Part B covers doctor visits, preventive care, lab work, X-rays, and outpatient hospital services. Once you meet your $240 deductible, Medicare pays 80 percent and you pay 20 percent for most of these services. For preventive visits — such as annual wellness exams, cancer screenings, and vaccinations — there is no coinsurance; Medicare covers them fully after you meet your deductible, and some preventive services are covered even before you meet it.

Part B does not cover dental, vision, hearing aids, or long-term care. It also does not cover most prescription drugs; that is Part D. If you need these services, you will pay out of pocket or enroll in a separate plan.

A typical doctor visit might cost $150. You would pay $30 (20 percent) after your deductible is met. A lab test billed at $200 would cost you $40. These costs add up quickly if you see multiple doctors or have chronic conditions, which is why many people buy a Medigap plan (also called Supplemental Insurance) to cover the 20 percent coinsurance, or choose a Medicare Advantage plan that caps out-of-pocket costs.

Premiums and deductibles for 2024 and how they change year to year

The 2024 Part B premium of $164.90 and deductible of $240 represent increases from 2023, when the premium was also $164.90 but the deductible was $226. Over the past decade, premiums have generally risen 2 to 4 percent per year, though some years see larger jumps. The deductible has risen more steeply, nearly doubling since 2015.

CMS sets these amounts based on expected costs for the coming year and announces them in October. If you are enrolled in Part B, you will receive a notice from Social Security or your Medicare plan showing your premium for January. If you disagree with the amount — for example, if you believe your income has changed — you have until the end of the year to request a recalculation.

Future increases are difficult to predict because they depend on healthcare inflation and the overall cost of services covered by Part B. Some years Congress has frozen the premium increase, but this is rare. Budget for the possibility that your premium will rise each year.

How to pay your Part B premium

If you are receiving Social Security benefits, your Part B premium is usually deducted automatically from your monthly check. If you are not yet on Social Security, or if you want to pay separately, you can set up automatic payments from your bank account through Medicare, or you can pay by check or online at Medicare.gov.

If you miss a premium payment, you have a grace period of three months to pay without losing coverage. After three months, your coverage ends. If you later want to re-enroll, you may face a permanent penalty of 10 percent added to your premium for each year you were not enrolled, unless you have a valid reason for the late enrollment (such as employer coverage).

If you cannot afford your Part B premium, ask your state Medicaid office whether you may have access to for Medicaid Buy-In or another program that pays premiums on behalf of low-income beneficiaries. may be able to access and program names vary by state, but many states offer this help.

Part B costs compared to Medicare Advantage and Medigap

Original Medicare (Part A and Part B) leaves you responsible for 20 percent coinsurance with no annual cap. If you have a serious illness or multiple chronic conditions, this can cost thousands of dollars per year. Many people add coverage to limit this risk.

Medigap plans are sold by private insurers and cover some or all of the 20 percent coinsurance you would otherwise pay. They do not change your doctor network; you keep your Medicare coverage and your doctors. Medigap premiums vary widely by plan type and location, typically ranging from $100 to $300 per month, but they are separate from your Part B premium.

Medicare Advantage plans (Part C) are an alternative to Original Medicare. You pay a Part B premium to Medicare, then a separate premium to the Advantage plan (often $0 to $50 per month). In exchange, you get a capped out-of-pocket maximum — typically $5,000 to $7,000 per year — and you usually must use doctors in the plan's network. Advantage plans often include dental, vision, and hearing coverage, which Original Medicare does not.

The choice between Original Medicare with Medigap, Original Medicare alone, and Medicare Advantage depends on your health, your doctors, and how much you can afford to spend out of pocket. There is no single right answer.

When your Part B costs might be higher or lower

Your premium is higher if your income was above the threshold two years ago. Your premium is lower if you delayed enrolling in Part B and are now paying a penalty, or if you may have access to for a state program that subsidizes premiums.

Your out-of-pocket costs (the 20 percent coinsurance) depend on how much medical care you use. If you are healthy and rarely see a doctor, you may pay only the deductible and a few small coinsurance amounts. If you have diabetes, heart disease, or cancer, you could easily spend $2,000 to $5,000 or more per year in coinsurance alone.

Some services have different cost-sharing rules. For example, mental health visits are covered at 20 percent coinsurance, the same as other doctor visits. Preventive services are fully covered. Durable medical equipment (like wheelchairs or oxygen) is covered at 20 percent after the deductible. Always check your Medicare Summary Notice or call Medicare at 1-800-MEDICARE to confirm what you will owe for a specific service before you have it done.

Frequently Asked Questions

Can I delay enrolling in Part B to avoid paying a premium?

You can delay Part B if you have employer coverage, but if you enroll late without a valid reason, Medicare adds a 10 percent penalty to your premium for each year you were not enrolled. This penalty is permanent. If you are no longer working and do not have coverage, enroll during your Initial Enrollment Period (the seven-month window around your 65th birthday) to avoid the penalty.

What happens if my income drops after I turn 65?

If your income falls significantly — for example, because you retired or lost a job — you can request that Medicare recalculate your premium using your current-year income instead of the income from two years ago. File form SSA-44 with Social Security and provide proof of the income change. The recalculation usually takes one to two months.

Does Part B cover my doctor's full bill?

Part B covers 80 percent of the Medicare-approved amount for most services. If your doctor accepts Medicare assignment (which most do), you pay 20 percent of that approved amount. If your doctor does not accept assignment, you may owe more. Always ask your doctor's office whether they accept Medicare assignment before your visit.

Will my Part B premium go up every year?

Most years, yes. Premiums have risen nearly every year for the past two decades, though the increase varies. Some years it is 1 to 2 percent; other years it is 5 to 8 percent. Budget for an increase each January and check your notice from Social Security to see the exact amount.

Is there a limit to how much I pay out of pocket for Part B services?

Original Medicare Part B has no annual out-of-pocket maximum. You pay 20 percent coinsurance for every service, with no cap. If you want a spending limit, you need to add a Medigap plan (which covers the coinsurance) or switch to a Medicare Advantage plan (which has a capped out-of-pocket maximum, usually $5,000 to $7,000 per year).