Get Your Free Medicare Part B Cost Guide

What Medicare Part B Covers and Costs

Medicare Part B is one part of the Original Medicare program run by the Centers for Medicare & Medicaid Services (CMS). Part B covers outpatient medical services, meaning care you receive outside of a hospital stay. Understanding what Part B pays for is essential to making decisions about your healthcare coverage.

Part B covers several types of services. Doctor visits, including preventive care like annual wellness exams and cancer screenings, are included. The program also covers certain laboratory tests, imaging services like X-rays and ultrasounds, and procedures performed in outpatient settings. Mental health services, including therapy and psychiatric care, fall under Part B coverage. Durable medical equipment such as wheelchairs, walkers, and oxygen equipment may be covered. Physical therapy, occupational therapy, and speech therapy also qualify for Part B benefits when ordered by a doctor.

The costs associated with Part B include a monthly premium, which is deducted from Social Security payments for most beneficiaries. For 2024, the standard monthly premium is $164.90, though this amount may vary based on income. Part B also involves a yearly deductible—$240 for 2024—which you must pay out of pocket before Medicare begins sharing costs. After meeting the deductible, you typically pay 20 percent of approved amounts for most services, while Medicare covers the remaining 80 percent.

It's important to note that Part B does not cover all medical services. Routine dental care, vision exams, hearing aids, and long-term custodial care in nursing homes are not covered. Prescription medications taken at home are covered under Part D, not Part B. Understanding these boundaries helps you anticipate what costs you may need to plan for separately.

Practical takeaway: Review the list of services covered by Part B to understand which of your regular healthcare needs may be paid for and which might require additional coverage or out-of-pocket payment.

Understanding Part B Premiums and Income-Related Adjustments

Part B premiums are not one-size-fits-all for everyone. While the standard premium applies to most beneficiaries, higher-income individuals pay more through a system called Income-Related Monthly Adjustment Amounts (IRMAA). This system was created to help ensure that those with higher incomes contribute more fairly to the program's costs.

IRMAA uses your income from two years prior to determine your premium amount. For example, in 2024, the CMS uses income information from 2022 tax returns. The income threshold used for IRMAA calculations is called Modified Adjusted Gross Income (MAGI). If your MAGI falls above certain levels, you'll pay a higher monthly premium in addition to the standard amount. For 2024, income thresholds start at $97,000 for individuals and $194,000 for married couples filing jointly. Those above these levels may pay anywhere from $10 to $560 more per month, depending on their income level.

It's possible to request a reconsideration of your IRMAA calculation if your income has decreased due to specific life events. These events include retirement, loss of income-producing property, or significant changes in your income situation. You must report these changes to Social Security within 60 days of the event. Providing documentation such as tax returns, divorce decrees, or termination letters helps support your request for a recalculation.

The annual premium amounts change each year. The Social Security Administration announces the new standard premium amount in late September for the following year. These adjustments are tied to the program's overall costs and inflation. By reviewing your Part B costs regularly, you can better plan your healthcare budget and understand what to expect in the coming year.

Practical takeaway: Check your Part B premium notice each year to see if IRMAA applies to you. If your income has changed significantly, contact Social Security to discuss whether your premium amount should be adjusted.

How to Obtain Your Free Medicare Part B Cost Guide

Several resources provide free guides and educational materials about Medicare Part B costs without charge to you. Medicare.gov, the official government website, offers publications and detailed information about how Part B costs work. You can visit the site to read online materials or request printed copies to be mailed to your home.

The State Health Insurance Assistance Program (SHIP) in your state provides free counseling services and educational materials about Medicare. SHIP counselors can review your specific situation and explain Part B costs as they relate to your healthcare needs. Each state operates its own SHIP, and you can find your local program through Medicare.gov or by calling 1-800-MEDICARE.

Area Agencies on Aging also distribute educational materials about Medicare costs and coverage. These agencies serve older adults in your community and often have trained staff who can answer questions about Part B. Many libraries and senior centers maintain stacks of Medicare educational materials that you can take home.

Some health insurance companies that offer Medigap or Medicare Advantage plans provide educational guides about Part B costs as well. These materials help consumers understand how their additional coverage works alongside Part B. When requesting information from insurance companies, you're receiving educational materials, not enrollment documents.

The 1-800-MEDICARE helpline operated by CMS provides information about obtaining educational resources. Representatives can mail you materials or direct you to local resources in your area. The service is available 24 hours a day, seven days a week, at no cost.

Practical takeaway: Gather the free Part B cost guide materials from at least two sources—such as Medicare.gov and your state's SHIP—so you have different perspectives on how costs break down and what to expect.

Breaking Down the 2024 Part B Cost Structure

The 2024 Medicare Part B cost structure includes several components that you should understand to plan your healthcare spending. The monthly premium of $164.90 is the most recognizable cost, but it's only the first part of what Part B involves.

The annual deductible of $240 must be paid by you before Medicare starts paying its share of approved charges. Once you've spent $240 on covered services during the calendar year, the deductible is considered met. After that point, you enter the cost-sharing phase where you and Medicare split the costs.

The coinsurance amount is typically 20 percent of the approved charge. This means if your doctor performs a service that Medicare approves as costing $100, you pay $20 and Medicare pays $80. The approved charge is not necessarily what your provider charges—Medicare determines the approved amount based on its fee schedule. If a provider charges more than the approved amount, you may be responsible for that difference depending on whether they accept Medicare assignment.

Part B has no annual out-of-pocket maximum. This means your coinsurance costs can continue throughout the year without a cap. If you develop a serious illness requiring extensive outpatient services, your 20 percent costs could accumulate significantly. This is one reason why many beneficiaries purchase Medigap insurance, which can cover coinsurance amounts and deductibles.

Some services may have different cost structures. For example, mental health services covered under Part B may be subject to different limits and cost-sharing amounts than other services. Preventive services with no cost-sharing—such as annual wellness exams and certain cancer screenings—are covered at no out-of-pocket cost to you once Part B covers them.

Practical takeaway: Create a simple spreadsheet tracking Part B costs you've incurred during the year—premiums, deductible payments, and coinsurance amounts—so you can see your cumulative spending and plan for upcoming expenses.

How Part B Fits Into Your Overall Medicare Picture

Medicare consists of four parts: Part A, Part B, Part D, and Part C. Each part covers different services, and understanding how they work together helps you grasp the complete picture of your healthcare coverage and costs.

Part A covers inpatient hospital services, skilled nursing facility care, hospice care, and some home health services. Part A has its own deductible, coinsurance amounts, and coverage limits. Most people pay no monthly premium for Part A because they or their spouse paid payroll taxes during their working years that funded this benefit. Part B, as discussed, covers outpatient services and physician care.

Part D covers prescription drug coverage through private insurance companies contracted with Medicare. Part D is separate from Part B and requires an additional monthly premium