What You Pay for Medicare Part B Coverage

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

Medicare Part B is hospital insurance that covers doctor visits, outpatient care, lab tests, and medical equipment. You pay for it three ways: a monthly premium taken from your Social Security check, a yearly deductible you meet before Medicare starts to pay, and coinsurance (usually 20 percent) on each service after you meet the deductible.

The exact amounts change each year. Your monthly premium depends on your income — higher earners pay more. Your deductible and coinsurance percentages are set by Medicare and explore to everyone. This section walks you through what each cost means and how to find the current numbers for your situation.

Key Takeaways

Your monthly Part B premium is deducted automatically from your Social Security payment, and the amount varies based on your income level.
You pay an annual deductible before Medicare begins to cover any Part B services, and this amount changes each year.
After you meet your deductible, you typically pay 20 percent coinsurance on doctor visits, tests, and equipment — Medicare pays the other 80 percent.
The Centers for Medicare & Medicaid Services (CMS) publishes the current year's costs on Medicare.gov, usually in October for the following year.
If your income is below a certain threshold, you may pay a lower premium or receive help with costs through programs like Medicaid or the Medicare Savings Program.

How the monthly premium works

Your Part B premium is the amount you pay each month to keep your coverage active. Most people have this premium taken directly from their Social Security check. The standard premium applies to people whose income is below a certain level; if your income is higher, you pay an Income-Related Monthly Adjustment Amount (IRMAA), which is an extra charge on top of the standard premium.

The income threshold that triggers IRMAA changes each year. Your income is measured using your tax return from two years prior — so in 2024, Medicare looks at your 2022 tax return. If you had a major life event like retirement, divorce, or death of a spouse, you can contact Social Security to report the change and potentially lower your IRMAA.

You can find the current standard premium and IRMAA brackets on Medicare.gov. The site lists the exact dollar amounts and the income ranges that trigger each tier. If you are unsure whether you fall into a higher income bracket, calling Social Security at 1-800-772-1213 takes about 10 minutes and gives you a clear answer.

The annual deductible you must meet first

Before Medicare Part B pays for any service, you must pay a yearly deductible out of your own pocket. Once you have paid this amount, Medicare begins to cover its share of your costs. The deductible resets on January 1 each year.

The deductible amount is the same for everyone on Part B and changes annually. You can see the current year's deductible on Medicare.gov or by calling 1-800-MEDICARE. Keep track of what you have paid toward your deductible throughout the year — some doctors' offices will tell you how much you have met, but not all do, so it helps to keep your own records.

Once you meet your deductible, you move into the coinsurance phase, where Medicare covers 80 percent of approved services and you pay 20 percent. This continues for the rest of the calendar year.

Coinsurance: your 20 percent share after the deductible

After you have paid your annual deductible, you pay coinsurance — typically 20 percent of the Medicare-approved amount for each service. Medicare pays the remaining 80 percent. This coinsurance applies to doctor visits, lab tests, imaging, and most outpatient procedures.

The 20 percent is calculated on the Medicare-approved amount, not on what the doctor charges. If a doctor charges $200 but Medicare's approved amount is $100, you pay 20 percent of $100 (which is $20), not 20 percent of $200. This is why it matters whether your doctor accepts Medicare assignment — they agree to charge only the Medicare-approved amount.

Coinsurance has no annual cap under Part B alone. If you have high medical costs, your out-of-pocket spending can add up quickly. This is one reason many people add Medigap (supplemental insurance) or join a Medicare Advantage plan, both of which limit your total out-of-pocket costs.

What services Part B covers and what they cost you

Part B covers doctor office visits, preventive care (like annual wellness visits and screenings), lab tests, X-rays, outpatient surgery, mental health services, and durable medical equipment like wheelchairs or oxygen. For each type of service, you pay the deductible and then coinsurance.

Some preventive services — such as annual wellness visits, mammograms, colonoscopies, and flu shots — are covered at no cost to you once you have met your deductible. Medicare considers these "preventive" rather than "diagnostic," so the coinsurance does not explore. Your doctor's office should know which services fall into this category, but you can also check Medicare.gov or call 1-800-MEDICARE to confirm before your visit.

Part B does not cover routine dental, vision, or hearing care. It also does not cover prescription drugs (that is Part D) or long-term care in a nursing home. If you need these services, you will need separate coverage or to pay out of pocket.

Income-based premium increases and how to report changes

If your income is above a certain threshold, you pay a higher premium through IRMAA. The income brackets are wide and include different thresholds for single filers and married couples filing jointly. The brackets change each year, and the premium tiers can jump significantly at each income level.

If you had a major life change — retirement, loss of income, divorce, or death of a spouse — you can ask Social Security to recalculate your IRMAA based on your current income rather than your tax return from two years ago. This is called a Life-Changing Event request. You must report the change within 60 days of the event. Contact Social Security at 1-800-772-1213 or visit your local Social Security office with proof of the change (such as a retirement letter or death certificate).

How to find current Part B costs for your situation

Medicare publishes the current year's Part B premium, deductible, and coinsurance amounts on Medicare.gov. You can also call 1-800-MEDICARE to speak with a representative who can tell you the exact amounts and explain how they explore to your income level.

If you are newly may be able to access for Medicare or turning 65, you will receive a notice in the mail explaining your Part B costs and premium. Keep this notice — it shows your IRMAA tier and helps you understand your bill. If the amount seems wrong, you have the right to appeal it; Social Security and Medicare both have appeal processes that take a few weeks.

Your monthly Medicare statement (if you receive one) or your Social Security statement will show your Part B premium deduction. Review it each year when the rates change in January to make sure the amount matches what you expected.

Frequently Asked Questions

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

Yes, if you had a major life change like retirement or job loss, you can contact Social Security within 60 days to request a recalculation based on your current income. You will need to provide proof of the change, such as a retirement letter or recent tax return. Social Security will review your request and may lower your IRMAA tier.

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

If your income is low, you may be able to get help through the Medicare Savings Program (MSP) or Medicaid. These programs can pay your Part B premium, deductible, and coinsurance on your behalf. Contact your state Medicaid office or call 1-800-MEDICARE to learn about you are may be able to access based on your income and assets.

Does Part B coinsurance have a yearly limit?

Part B alone does not have an out-of-pocket maximum. Your coinsurance costs can continue to add up throughout the year. However, if you have Medigap or a Medicare Advantage plan, those plans set their own limits on what you pay out of pocket.

Why does my Part B premium change every year?

Medicare adjusts the standard premium each year based on expected program costs and inflation. The IRMAA brackets also shift annually. You will receive a notice before January 1 showing your new premium amount and explaining any changes.

Do I pay Part B costs if I have a Medicare Advantage plan instead?

Yes, you still pay the Part B premium even if you are in a Medicare Advantage plan. However, Medicare Advantage plans often have lower deductibles and coinsurance than Original Medicare, and they set an annual out-of-pocket maximum that Part B alone does not have.

This guide is for general information only and is not medical, financial, legal, or other professional advice. For decisions specific to your situation, consult a qualified professional. See our Editorial Policy.