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

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 Part B starts paying, and coinsurance (usually 20 percent) on each service after the deductible. The exact amounts change every year and depend partly on your income.

For 2024, the standard monthly premium is $164.90, the annual deductible is $240, and you typically pay 20 percent of the cost of services once you have met the deductible. However, if your income is higher than a certain threshold, you will pay more — sometimes significantly more. These figures are set by Medicare and announced each fall for the following year.

Key Takeaways

  • The 2024 Part B premium is $164.90 per month for most people, but higher earners pay more based on income brackets set two years prior.
  • You must meet a $240 annual deductible before Part B begins to cover its share of costs.
  • After the deductible, you typically pay 20 percent coinsurance on doctor visits, tests, and most outpatient services.
  • Part B premiums and deductibles increase most years, so your 2025 costs will likely differ from 2024.
  • If you delay enrolling in Part B after you first become may be able to access, you may face a permanent penalty on your premium.

How the monthly premium is calculated

Your Part B premium depends on your income from two years ago. Medicare uses your Modified Adjusted Gross Income (MAGI) from your tax return to sort people into income brackets. If your income falls below the threshold, you pay the standard premium. If it is higher, you pay the standard amount plus an extra surcharge called an Income-Related Monthly Adjustment Amount (IRMAA).

For 2024, the income thresholds are $97,000 for single filers and $194,000 for married couples filing jointly. If your 2022 income was above these amounts, your 2024 premium will be higher. The surcharge can range from about $66 to over $500 per month depending on how much your income exceeds the threshold. You can request a recalculation if your income dropped due to retirement, job loss, or death of a spouse — Medicare will use your current-year income instead.

The annual deductible and coinsurance

Before Part B pays for any service, you must pay the annual deductible out of your own pocket. For 2024, this is $240. Once you have paid $240 in covered services, Part B begins to share the cost with you. After that point, you typically pay 20 percent of the Medicare-approved amount for most services, and Part B pays 80 percent.

This 20 percent coinsurance applies to doctor office visits, lab work, imaging (X-rays, CT scans), and outpatient hospital services. However, some services have different cost-sharing rules. Preventive services like annual wellness visits and cancer screenings are covered at no cost after you meet the deductible. Mental health visits and physical therapy follow the same 20 percent coinsurance rule. Durable medical equipment (wheelchairs, oxygen, walkers) typically costs 20 percent as well.

What Part B does not cover

Part B does not cover routine dental care, vision exams for glasses or contacts, hearing aids, or long-term care in a nursing home. It also does not cover most prescription drugs — that is Part D. Routine foot care, cosmetic surgery, and acupuncture are not covered unless they meet specific medical criteria. If you receive a service Part B does not cover, you pay the full cost yourself.

Understanding what Part B excludes helps you plan for other coverage. Many people buy a Medigap (supplemental insurance) policy to cover the 20 percent coinsurance Part B leaves you responsible for, or they enroll in a Medicare Advantage plan that bundles Part B, Part D, and often dental and vision into one plan with different cost structures.

Income-related surcharges and how they work

If your income is above the threshold, Medicare calculates a surcharge based on which income bracket you fall into. There are five brackets, and the surcharge increases as your income rises. For example, in 2024, a single person with income between $97,001 and $123,000 pays an extra $66 per month. Someone with income above $500,000 pays an extra $560 per month on top of the standard premium.

The income used is from your tax return from two years prior. This means your 2024 surcharge is based on 2022 income, and your 2025 surcharge will be based on 2023 income. If your circumstances change — you retire, lose a job, or experience a major life event — you can request that Medicare use your current-year income instead. You must submit a form and provide documentation of the change within 60 days of the event.

When premiums increase and how to plan for them

Part B premiums and deductibles typically increase each year. The amount of the increase is tied to inflation and changes in healthcare costs. In recent years, increases have ranged from about 5 percent to over 14 percent annually. Medicare announces the new premium and deductible amounts in October for the following year.

If you are on Social Security, your Part B premium is deducted automatically from your monthly benefit. If you are not yet on Social Security, you receive a bill from Medicare each month. Budget for a premium increase each year, especially if your income is rising or if you are approaching an income threshold that would trigger a surcharge. Reviewing your income and Part B costs each fall can help you plan ahead.

Late enrollment penalties

If you do not enroll in Part B when you first become may be able to access (usually at age 65), you may face a permanent penalty. The penalty is 10 percent of the standard premium for each full year you delay enrollment without a valid reason. This penalty stays with you for life, even if you later enroll.

There are exceptions: if you are still working and covered by your employer's health plan, or if you are a federal employee, you may be able to delay Part B without penalty. You must enroll within eight months of losing that coverage. If you miss this window, the penalty applies. It is important to enroll on time or document the reason you delayed, because the penalty is difficult to remove once it is applied.

Frequently Asked Questions

Does Part B cover preventive care at no cost?

Yes. Preventive services like annual wellness visits, cancer screenings, and vaccinations are covered at no cost after you meet the deductible. However, if your doctor finds a problem during a preventive visit and performs additional testing or treatment, you may owe coinsurance on those additional services.

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

Yes. If you retire, lose a job, or experience another major life event that lowers your income, you can request that Medicare recalculate your surcharge using your current-year income instead of the prior-year amount. You must submit the request within 60 days of the event and provide documentation.

What happens if I cannot afford my Part B premium?

Medicare has programs to help low-income beneficiaries pay premiums and cost-sharing. Medicaid, the may have access to Medicare Beneficiary (QMB) program, and the Specified Low-Income Medicare Beneficiary (SLMB) program may cover some or all of your costs. Contact your state Medicaid office or local Area Agency on Aging to learn what you may be able to access.

Does Part B premium change if I move to a different state?

No. Part B premiums are the same nationwide. Your state does not affect your premium amount, though some states offer additional programs to help with costs. Your income and age are what determine your premium.

Can I drop Part B if I have Medicare Advantage?

No. Medicare Advantage is an alternative way to receive Part A and Part B benefits, but you must be enrolled in both Part A and Part B to use it. You cannot drop Part B while keeping Medicare Advantage. You can switch between Original Medicare and Medicare Advantage during the annual enrollment period.