The 2024 Medicare Part B monthly premium is $164.90 for most people, but the amount you pay depends on your income and when you first enrolled.

Medicare Part B covers doctor visits, outpatient care, lab tests, and medical equipment. The monthly premium is separate from what you pay for Part A (hospital insurance) and any supplemental coverage you choose. The standard premium changes each year — it went up from $164.90 in 2023 — and the amount you owe can be higher or lower depending on your income level and whether you delayed enrollment.

If you enrolled in Part B when you first became may be able to access at 65, you pay the standard premium. If you delayed enrollment and signed up later, you may pay a permanent surcharge called a late enrollment penalty, which adds roughly 10 percent to your premium for each year you waited. That penalty stays with you for life, even if your income changes.

Key Takeaways

  • The standard 2024 Part B premium is $164.90 per month for most beneficiaries, though this amount changes yearly.
  • Higher-income individuals pay more through Income-Related Monthly Adjustment Amounts (IRMAA), with premiums ranging from $164.90 to $560.50 depending on tax filing status and income thresholds.
  • Delaying Part B enrollment past your initial may be able to access window triggers a permanent late enrollment penalty of approximately 10 percent per year of delay.
  • Your premium is deducted automatically from your Social Security check unless you choose to pay Medicare directly.

How income affects what you pay

If your income exceeds certain thresholds, Medicare adds an Income-Related Monthly Adjustment Amount (IRMAA) to your standard premium. This surcharge is based on your modified adjusted gross income from your tax return from two years prior — so in 2024, Medicare looks at your 2022 tax return.

For 2024, the income thresholds for single filers start at $97,000 and for married couples filing jointly at $194,000. If you fall into a higher income bracket, your Part B premium can range from $164.90 up to $560.50 per month. The exact amount depends on which income tier you land in. Medicare sends you a notice each year showing your IRMAA calculation and the income figure they used.

If your income drops significantly — due to retirement, divorce, or death of a spouse — you can request that Medicare recalculate your IRMAA using your current year's income instead of the two-year-old tax return. This is called a life-changing event appeal, and you have until December 31 of the year following the event to file it.

When and how your premium gets paid

Your Part B premium is normally deducted directly from your Social Security payment each month. If you are not yet receiving Social Security, or if you choose not to have it deducted, Medicare sends you a bill. The payment is due by the end of the month for coverage that month.

If you miss a payment, Medicare will send you a notice. You have a grace period to pay, but if you do not pay within three months, your Part B coverage can be terminated. You would then have to wait until the next general enrollment period (January 31 to March 31) to re-enroll, and you would owe a late enrollment penalty.

Late enrollment penalties and how they work

The late enrollment penalty applies if you did not sign up for Part B during your Initial Enrollment Period — the seven-month window that includes the month you turn 65, plus three months before and three months after. If you delayed and enrolled later, you pay roughly 10 percent more than the standard premium for each full year you were not enrolled.

For example, if you delayed enrollment by three years and the standard premium is $164.90, your penalty would be approximately 30 percent of that amount, added to your premium permanently. This penalty does not go away if you move to a different state, switch to a different Medicare plan, or if your income changes. It stays on your record as long as you have Part B coverage.

There are exceptions to the late enrollment penalty. If you had creditable coverage through an employer or union while you were working, or through a spouse's employer, you may not owe a penalty. You must show proof of that coverage when you enroll.

Part B premiums compared to other Medicare costs

Part B premium is only one piece of what Medicare costs. You also pay a Part B deductible — $240 in 2024 — before Medicare starts paying for most doctor visits and outpatient services. After you meet the deductible, you typically pay 20 percent of the cost of covered services, and Medicare pays 80 percent.

If you have Part D (prescription drug coverage), that has its own monthly premium, which varies by plan and insurance company. If you have a Medigap or Medicare Advantage plan, those have separate premiums as well. Your total monthly Medicare cost is the sum of all these pieces.

Many people find it helpful to compare the total cost of different plan types — Original Medicare plus Medigap, or Medicare Advantage — before the year begins, because you can only change plans during the annual enrollment period (October 15 to December 7).

What happens if you cannot afford the premium

If your income is very low, you may be able to get help paying your Part B premium through a program called Medicaid or a Medicare Savings Program. These programs are run by your state, not by Medicare directly, and income limits vary by state.

To find out whether you may have access to, contact your state Medicaid office or call 1-800-MEDICARE to ask about Medicare Savings Programs in your area. You can also visit your local Area Agency on Aging, which can help you understand what programs might be available to you based on your income and situation.

Frequently Asked Questions

Can I change my Part B premium payment method?

Yes. If your premium is currently deducted from Social Security, you can request to pay Medicare directly instead by calling 1-800-MEDICARE. If you are not receiving Social Security, you can choose to have Medicare bill you monthly or set up automatic payments from your bank account.

What if I disagree with my IRMAA calculation?

You can request a reconsideration by calling Social Security at 1-800-772-1213. If your income has dropped due to a life-changing event like retirement or divorce, you can file an appeal and ask Medicare to use your current year's income instead of the two-year-old tax return.

Do I have to pay Part B premium if I am still working?

Yes, unless you have health coverage through your employer or union that is considered creditable coverage. If you do have employer coverage, you can delay Part B enrollment without penalty, but you must enroll within eight months of losing that coverage to avoid a late penalty.

Will my Part B premium increase every year?

Yes, the standard premium typically increases each year based on program costs and inflation. The exact increase is announced in the fall for the following year. If your income stays the same, your IRMAA tier may also change if the income thresholds shift.

What if I move to a different state?

Your Part B premium does not change if you move. The premium is the same across all states. However, if you move, you may want to review your Medicare Advantage or Medigap plan, because not all plans are available in every state.