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

Your Medicare Part B premium — the monthly charge — is based on your income. Most people pay the standard amount, which changes each year. In 2024, the standard premium is $164.90 per month, but higher earners pay more through a process called Income-Related Monthly Adjustment Amount (IRMAA). Your actual premium depends on your tax return from two years prior.

Beyond the monthly premium, you also pay a yearly deductible before Medicare starts to cover your doctor visits and outpatient services. Once you meet that deductible, you typically pay 20 percent of the cost for most services, while Medicare pays 80 percent. Some services — like preventive care — have no cost-sharing at all.

Part B does not cover everything. You are responsible for the full cost of services Medicare does not cover, such as routine dental work, vision exams, or hearing aids. Understanding what Part B includes and what it leaves out helps you plan for out-of-pocket costs and decide whether you need supplemental coverage.

Key Takeaways

  • The standard Part B premium in 2024 is $164.90 per month, but you may pay more if your income exceeds certain thresholds.
  • You pay an annual deductible before Medicare covers outpatient services, and then you typically pay 20 percent of costs for most doctor visits and tests.
  • Preventive services like screenings and vaccines are covered with no cost-sharing, but dental, vision, and hearing care are not covered by Part B.
  • Your actual costs depend on which services you use, whether you see in-network providers, and whether you have supplemental insurance.

How the Monthly Premium Works

The standard Part B premium is set by Medicare each year and applies to most people. However, if your modified adjusted gross income (MAGI) — calculated from your tax return from two years before — exceeds a certain amount, you pay an additional surcharge called IRMAA. The income thresholds and surcharge amounts change annually.

Your premium is usually deducted automatically from your Social Security check. If you do not receive Social Security, Medicare bills you directly. If you delay enrolling in Part B after you first become may be able to access, you may face a permanent penalty added to your premium for as long as you have Part B coverage.

The Annual Deductible and Cost-Sharing

Each calendar year, you must pay a deductible out of your own pocket before Medicare begins to share the cost of outpatient services. The deductible amount changes yearly. Once you have paid the deductible, Medicare covers 80 percent of the approved amount for most services, and you pay the remaining 20 percent.

This 20 percent cost-sharing applies to doctor visits, lab tests, imaging, and many other outpatient services. However, some services fall outside this structure. Preventive services — such as annual wellness visits, cancer screenings, and vaccinations — are covered at no cost to you once you have met your deductible, or in some cases with no deductible required.

Services Covered at No Cost

Medicare Part B covers certain preventive services with zero cost-sharing. These include your annual wellness visit, colorectal cancer screening, mammograms, bone density tests, diabetes screening, and most vaccinations. You do not pay a copay, coinsurance, or deductible for these services when you see an in-network provider.

The full list of covered preventive services is available on Medicare.gov. Because coverage rules change, it is worth checking the current list before your appointment to confirm that a specific screening or vaccine is covered without cost.

What Part B Does Not Cover

Part B does not cover routine dental care, dentures, dental implants, or routine vision exams and eyeglasses. Hearing aids and routine hearing exams are also not covered. Long-term care, custodial care, and most prescription drugs are excluded as well — prescription drugs require Part D coverage.

If you need these services, you can purchase them out of pocket, enroll in a separate dental or vision plan through a private insurer, or explore whether a Medicare Advantage plan in your area offers dental or vision benefits as an add-on.

How Income Affects Your Premium

If your income is above certain thresholds, you pay a higher Part B premium through IRMAA. The thresholds are based on your filing status and your MAGI from two years prior. For example, in 2024, single filers with MAGI above $97,000 pay a surcharge in addition to the standard premium.

If your income drops due to retirement, job loss, or other life changes, you can request that Medicare recalculate your premium based on your current year's income instead of the two-year-old tax return. You must file a form called the Life-Changing Event form with Social Security to request this adjustment.

Supplemental Insurance and Medicare Advantage

Because Part B leaves you responsible for 20 percent of costs and does not cover dental, vision, or hearing, many people purchase additional coverage. A Medigap policy (supplemental insurance) helps pay the 20 percent coinsurance and may cover some services Part B does not. Medigap policies have their own premiums and rules.

Alternatively, you can enroll in a Medicare Advantage plan (Part C), which is an all-in-one alternative to Original Medicare. Medicare Advantage plans often include dental, vision, and hearing benefits, but they typically have lower out-of-pocket limits and may require you to use in-network providers. You still pay the Part B premium if you choose Medicare Advantage.

Frequently Asked Questions

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

Yes. If you experienced a major life change — such as retirement, job loss, or divorce — that lowered your income, you can ask Social Security to recalculate your premium based on your current year's income instead of the two-year-old tax return. Contact Social Security to request a Life-Changing Event form and submit documentation of the change.

Do I have to pay the Part B deductible every year?

Yes. The deductible resets on January 1 each year. Once you meet it, you pay only coinsurance (usually 20 percent) for most services for the rest of that calendar year. Preventive services do not count toward the deductible.

What happens if I do not enroll in Part B when I first become may be able to access?

You may face a permanent premium penalty. For each 12-month period you delay enrollment after you first become may be able to access, your premium increases by 10 percent for as long as you have Part B. There are limited exceptions, such as if you have employer coverage.

Does Part B cover prescription drugs?

No. Prescription drugs are covered under Medicare Part D, which is a separate enrollment. You can enroll in a Part D plan through a private insurer during the annual enrollment period or when you first become may be able to access for Medicare.

Are there any out-of-pocket limits with Part B?

Original Medicare Part B does not have an annual out-of-pocket limit, meaning your costs can continue to accumulate. Medicare Advantage plans do have annual out-of-pocket limits. If you are concerned about unlimited costs, consider a Medigap policy or Medicare Advantage plan.