Medicare Part B costs you a monthly premium, an annual deductible, and a percentage of most doctor visits and services
The amount you pay for Medicare Part B changes each year. Your monthly premium in 2024 is based on your income from two years ago — most people pay $164.90 per month, but higher earners pay more. You also pay a $240 annual deductible (as of 2024), then 20 percent of the cost of most doctor visits, lab work, and outpatient care after that.
Part B covers doctor visits, preventive care, outpatient hospital services, and medical equipment. It does not cover hospital stays (that is Part A), prescription drugs (that is Part D), or long-term care. Understanding what you actually pay — not just the premium — helps you budget for healthcare and know when to use in-network providers.
Key Takeaways
- Your Part B premium depends on your income from two years prior, so higher earners pay $200 to $560 per month instead of the standard rate.
- After you meet your annual deductible, you pay 20 percent of approved charges for doctor visits, lab tests, imaging, and outpatient procedures.
- Part B premiums and deductibles change every January, so check your Medicare statements each fall to see what your costs will be.
- If you delay enrolling in Part B without a valid reason, you may pay a permanent penalty on top of your premium for the rest of your life.
How the monthly premium is calculated
Your Part B premium is tied to your Modified Adjusted Gross Income (MAGI) from your tax return two years before the current year. If you are turning 65 in 2024, Medicare looks at your 2022 tax return. Most people pay the standard premium, but if your income was above a certain threshold, you pay an Income-Related Monthly Adjustment Amount (IRMAA) on top of it.
The income thresholds change yearly. For 2024, single filers earning more than $97,000 and married couples filing jointly earning more than $194,000 pay higher premiums. The more you earned, the more you pay — it can reach $560 per month for the highest earners. If your income drops significantly (retirement, job loss, divorce), you can ask Medicare to recalculate your premium using your current year's income instead.
You pay your Part B premium whether you use Medicare or not. It comes out of your Social Security check automatically, or Medicare bills you directly if you do not receive Social Security.
The deductible and coinsurance you pay per visit
Once you enroll in Part B, you pay a yearly deductible before Medicare starts sharing the cost. In 2024, that deductible is $240. After you meet it, you pay 20 percent of what Medicare approves for most services — doctor visits, lab tests, X-rays, physical therapy, and outpatient surgery.
The 20 percent applies to the approved amount, not what a doctor might bill. If a doctor bills $200 but Medicare approves only $150, you pay 20 percent of $150, not $200. This is why using in-network providers (those who accept Medicare assignment) protects you from surprise bills.
Some services have different cost-sharing rules. Preventive care covered by Part B — like annual wellness visits, cancer screenings, and vaccines — usually costs you nothing after you meet your deductible. Mental health visits follow the same 20 percent rule as other doctor visits.
What Part B does and does not cover
Part B pays for medically necessary services: office visits with doctors and specialists, lab work, imaging (X-rays, ultrasounds, MRIs), outpatient surgery, physical and occupational therapy, home health services, and durable medical equipment like wheelchairs and oxygen. It also covers preventive services with no cost-sharing — annual wellness exams, cancer screenings, diabetes management, and most vaccines.
Part B does not cover hospital inpatient stays (Part A handles that), prescription drugs (Part D), dental care, vision exams or glasses, hearing aids, or long-term nursing home care. If you need these services, you either pay out of pocket or enroll in Part D (for drugs) and supplemental coverage (Medigap or Medicare Advantage) to fill the gaps.
Income-related premiums and how they work
If you earned above the income threshold two years ago, Medicare automatically charges you more. For 2024, the brackets are:
| Income (Single Filer) | Income (Married Filing Jointly) | Monthly Premium |
|---|---|---|
| $97,000 or less | $194,000 or less | $164.90 (standard) |
| $97,001–$123,000 | $194,001–$246,000 | $230.80 |
| $123,001–$153,000 | $246,001–$306,000 | $329.70 |
| $153,001–$183,000 | $306,001–$366,000 | $428.60 |
| Over $183,000 | Over $366,000 | $560.50 |
These thresholds and amounts change yearly. If your income drops — you retire, sell a business, or go through divorce — you can request a Life Changing Event adjustment. Medicare will recalculate using your current year's income instead. You have 60 days from the event to request this change.
Penalties for late enrollment
If you do not enroll in Part B when you first become may be able to access (usually at 65), and you do not have other may have access to coverage, you pay a permanent penalty. The penalty is 10 percent of the standard premium for each full year you delayed, added to your premium forever. If you waited three years, you pay an extra 30 percent on top of your premium for life — even after you finally enroll.
The exception is if you had creditable coverage — employer health insurance or TRICARE — when you turned 65. If you were still working and covered by your employer's plan, you can enroll in Part B without penalty when you leave that job or lose the coverage, as long as you enroll within eight months.
How Part B fits with other Medicare coverage
Part B is one piece of Original Medicare. Part A covers hospital stays, and together they form the foundation. Most people also enroll in Part D (prescription drug coverage) and either Medigap (supplemental insurance) or Medicare Advantage (an all-in-one alternative plan) to cover the gaps Part A and B leave.
If you choose Medicare Advantage instead of Original Medicare, you still pay your Part B premium, but the Advantage plan replaces Part A and B coverage. You pay the plan's copays and deductibles instead of the 20 percent coinsurance. Advantage plans often include prescription drug coverage and dental or vision benefits, but you must use in-network providers except in emergencies.
If you choose Medigap, you keep Original Medicare (Part A and B) and buy a private policy to cover the deductible and coinsurance. You pay both your Part B premium and the Medigap premium, but you have more flexibility in choosing providers.
Frequently Asked Questions
Can I lower my Part B premium if my income drops?
Yes. If you retire, lose income, or experience a major life change, you can ask Medicare to recalculate your premium using your current year's income instead of the income from two years ago. You must request this within 60 days of the event. Contact Social Security or Medicare directly to file a Life Changing Event form.
What happens if I do not pay my Part B premium?
If you do not pay, Medicare will drop your coverage. You can lose Part B and have to wait until the next general enrollment period (January 1 to March 31) to re-enroll, which may trigger a late enrollment penalty. It is best to contact Medicare when ready if you are having trouble paying.
Do I pay Part B costs if I use preventive care?
No. Preventive services covered by Part B — like annual wellness visits, cancer screenings, blood pressure checks, and most vaccines — cost you nothing after you meet your deductible. However, if your doctor finds a problem during a preventive visit and treats it, that treatment may be subject to the 20 percent coinsurance.
Is Part B worth it if I am still working?
If your employer offers health insurance, you can delay Part B without penalty as long as you enroll within eight months of leaving that job or losing the coverage. Once you retire or lose employer coverage, enroll promptly to avoid the permanent late penalty.
Do Part B costs change every year?
Yes. Premiums, deductibles, and income thresholds all change on January 1 each year. Medicare announces the new amounts in the fall, and you will see them in your annual notice. Check your notice carefully so you know what to budget for the coming year.