The Medicare Part B Premium in 2024

The standard Medicare Part B premium for 2024 is $164.90 per month if you enroll when you first turn 65. This amount comes out of your Social Security check automatically, or you pay it directly to Medicare if you do not receive Social Security benefits yet.

The premium changes every January based on the cost of doctor visits and outpatient services covered by Part B. The amount you pay depends on your income from two years ago — not your current income. If you earned more in that earlier year, you will pay a higher premium through something called Income-Related Monthly Adjustment Amount (IRMAA).

Part B covers doctor visits, lab tests, X-rays, outpatient surgery, and some medical equipment. It does not cover hospital stays (that is Part A) or prescription drugs (that is Part D). You also pay a yearly deductible and a percentage of costs after that, separate from the premium.

Key Takeaways

  • The standard Part B premium for 2024 is $164.90 per month, but you may pay more if your income two years ago exceeded certain thresholds.
  • Your premium comes directly out of your Social Security payment each month, or you pay Medicare directly if you do not yet receive Social Security.
  • Part B covers doctor visits, outpatient care, and some equipment, but you still owe a $240 yearly deductible and 20 percent of most costs after that.
  • If you delay enrolling in Part B after age 65 without other coverage, you will pay a permanent penalty of 10 percent more for each year you waited.

How Income Affects Your Part B Premium

If your Modified Adjusted Gross Income (MAGI) from two years ago was above a certain amount, Medicare charges you extra on top of the standard premium. For 2024, if you filed taxes as a single person and your MAGI was over $97,000, you enter the higher premium brackets. If you filed as married filing jointly, the threshold is $194,000.

The income brackets create five tiers. At the lowest tier above the standard rate, you pay roughly $230 per month instead of $165. At the highest tier, you can pay over $560 per month. Medicare sends you a letter in November telling you which tier you fall into for the coming year.

You can challenge the income amount Medicare used if your circumstances changed — for example, if you retired that year or had a large one-time gain. You have 60 days from the date on the letter to request a review. Medicare will ask for tax returns or other proof of the change.

When Your Premium Increases and Why

The standard Part B premium rises most years because the cost of medical services goes up. Congress does not set the premium directly; instead, Medicare calculates it based on expected spending for the coming year. The increase is announced in September and takes effect the following January.

Your personal premium can also jump if your income rises above a new threshold. This happens automatically — you do not have to do anything. Medicare recalculates your IRMAA every year using your tax return from two years prior, so a promotion, inheritance, or large investment gain in one year will affect your premium two years later.

If you move to a different state, your premium does not change. Part B is the same price nationwide. However, what you pay out of pocket for actual medical care can vary by region because doctors and hospitals charge different amounts.

The Penalty for Enrolling Late in Part B

If you do not enroll in Part B when you first turn 65, and you do not have other health coverage through an employer or union, you will owe a late enrollment penalty. This penalty is 10 percent of the standard premium for each full year you delayed. If you wait three years, you pay 30 percent extra forever — not just for a few years, but for the rest of your life.

The penalty applies even if you enroll years later. If the standard premium is $165 and you delayed three years, you would pay an extra $49.50 per month permanently. This penalty does not go away if you move to a different state or change your coverage later.

You can avoid the penalty if you had creditable coverage — health insurance through a current or former employer, a spouse's employer, TRICARE, the Veterans Administration, or certain other sources. You have eight months after that coverage ends to enroll in Part B without penalty. If you are unsure whether your coverage counted, contact Medicare before your enrollment window closes.

What Part B Actually Covers and What It Does Not

Part B pays for visits to doctors, specialists, and nurse practitioners. It covers lab work, imaging (X-rays and ultrasounds), outpatient surgery at a hospital or surgery center, and some medical equipment like wheelchairs or oxygen. It also covers some preventive services with no cost to you, such as annual wellness visits and certain cancer screenings.

Part B does not cover hospital stays — that is Part A. It does not cover prescription drugs, dental care, vision care, hearing aids, or long-term care. It does not cover routine foot care, most cosmetic surgery, or experimental treatments not yet approved by the Food and Drug Administration.

After you pay your yearly deductible ($240 in 2024), Medicare pays 80 percent of the approved amount for most services, and you pay 20 percent. This is called coinsurance. If a doctor does not accept Medicare assignment, you may owe more than 20 percent.

How to Pay Your Part B Premium

If you receive Social Security, your Part B premium is deducted automatically from your monthly check. You will see the amount listed on your Social Security statement. If you do not receive Social Security yet, Medicare sends you a bill each month, usually by mail. You can pay by check, automatic bank withdrawal, or credit card.

If you enroll in a Medicare Advantage plan (Part C) instead of Original Medicare, you still pay the Part B premium to Medicare, plus any additional premium the Advantage plan charges. If you enroll in a Medigap policy (supplemental insurance), you pay the Part B premium to Medicare and a separate premium to the Medigap insurer.

If you cannot afford your Part B premium, you may be able to get help through Medicaid or the Medicare Savings Program in your state. These programs pay part or all of your premium if your income and assets fall below certain limits. Contact your state Medicaid office or call 1-800-MEDICARE to learn whether you may have access to.

Frequently Asked Questions

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

Yes. If your income fell significantly — for example, because you retired or had a major loss — you can request that Medicare recalculate your IRMAA using your current year's income instead of the two-year-old figure. You have 60 days from the date on your premium notice to file a request. Medicare will ask for proof of the change, such as a recent tax return or a letter from your employer.

What happens if I do not pay my Part B premium?

If you miss a payment, Medicare will send you a notice. If you do not pay within three months, Medicare can disenroll you from Part B. Once you are disenrolled, you cannot re-enroll until the next general enrollment period (January 1 to March 31), and you will owe the late enrollment penalty unless you have a valid reason for the gap.

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

No. The Part B premium is the same in every state. However, your out-of-pocket costs for actual medical care may change because doctors and hospitals in different regions charge different amounts. Your deductible and coinsurance percentage stay the same nationwide.

Can I have Part B and Medicare Advantage at the same time?

You must have Part B to enroll in a Medicare Advantage plan, so yes, you pay both premiums. You pay the Part B premium to Medicare and the Advantage plan premium (if any) to the insurance company. Some Advantage plans charge no additional premium beyond Part B, while others charge $50 to $200 or more per month.

What if my employer still covers me at age 65?

If your employer has 20 or more employees and you are still working, you can delay Part B without penalty. You have eight months after you leave your job or lose coverage to enroll without owing the late penalty. Make sure to enroll during that window, or the penalty will explore.