Part B, which helps millions of Americans pay for medical care, requires certain costs, two of which are premiums and deductibles. The prices are set by federal law, but the exact amount you’ll pay varies depending on certain factors like your income. Read on for details about Part B premiums and deductibles, from cost amounts to how to pay them.
The Cost of Medicare Part B Premiums
A premium is the monthly cost that you pay for health insurance. For coverage, the Social Security Administration determines the Medicare Part B premium amount, based on your income.
In general, this means that the higher your income is, the higher premium you’ll pay. Social Security uses the modified adjusted gross income (MAGI) that you reported on your taxes the year before. For example, to determine your 2018 premium, Social Security uses the income you earned in 2017 and reported when you filed your taxes in 2018.
The standard premium is the amount that most people pay and applies to individuals with incomes up to $85,000 per year ($170,000 for married couples filing jointly). If you enroll in Part B for the first time in 2019, the standard premium is $135.50. For new enrollees who signed up in 2018, the standard premium is $134.00.
People who earn more than the standard premium threshold will pay higher premiums. This premium increase is called the Income-Related Monthly Adjusted Amount (IRMAA).1
The table below outlines the 2019 premiums by income.
|Your 2017 yearly income||Your 2019 Part B premium if you filed an individual tax return|
|Up to $85,000||$135.50|
|$85,000 – $107,000||$189.60|
|$107,000 – $133,000||$270.90|
|More than $500,000||$460.50|
|Your 2017 yearly income||Your 2019 Part B premium If you filed a joint tax return|
|Up to $170,000||$135.50|
|More than $750,000||$460.50|
|Your 2017 yearly income||Your 2019 Part B premium If you filed a married and separate tax return|
|Up to $85,000||$135.50|
|More than $415,000||$460.50|
Social Security recipients
If you already have Medicare and you get Social Security benefits, you may pay less than the standard premium. This is due to the “hold harmless” provision, which says those who have premiums taken from their Social Security won’t see their benefit checks reduced if premiums increase due to a cost-of-living adjustment (COLA). Contact Social Security to find out exactly how much your Part B premium will be.
If you qualify for Medicaid, your state’s Medicaid program will pay the standard premium for you.
How to pay your Part B premium
You’ll pay your premium in one of two ways, depending on whether you receive additional benefits from the federal government.
If you enroll in Part B for the first time in 2019, the standard premium is $135.50. For new enrollees who signed up in 2018, the standard premium is $134.00.
If you receive any of the retirement benefits below, your premium will be automatically deducted from your monthly benefit payment.
- Social Security
- Railroad Retirement Board (RRB)
- Office of Personnel Management
If you don’t receive any of these benefits, you’ll get a bill from Social Security that you can pay with a check.
Part B includes a yearly deductible. This is the amount you must pay for most health care services before Part B starts to help. The federal government sets the deductible, and it may change from year to year, similar to the premium.
For new plans in 2019, the deductible is $185.00. It was $183.00 for 2018 enrollees. After you meet the deductible, it pays 80% of the Medicare-approved amount for medically necessary services like doctor visits, outpatient therapy, and durable medical equipment. You pay the remaining 20%, which is called “coinsurance.”
How to pay your Part B deductible
You don’t pay your deductible to Medicare; you pay it to your health care providers directly. The doctor, specialist, or facility may ask for a deductible payment at the time they provide you care, or they may bill you later. Either way, your provider should file a claim with Medicare for the services.
Once your deductible is satisfied, you’ll pay your coinsurance to the provider for additional costs.
There are more costs in addition to the premium and deductible. These include coinsurance (as mentioned above), copayments, and costs for other programs.
- Coinsurance: This is a percentage that you pay for most services after you meet your deductible. For most services, your coinsurance is 20% of the Medicare-approved amount.
- Copayments: These are set dollar amounts you pay for certain services with some Advantage Plans.
- Part A Costs: If you have Part B, you also have Part A (hospital insurance). Most people get Part A premium free, but you may pay a deductible and/or coinsurance for covered Part A services like hospital stays and visits to skilled nursing facilities.
- Part C Costs: These plans often include different costs for services and extra benefits—like dental and vision—than what you normally pay for Original Part B.
- Part D Costs: If you have prescription drug coverage, you’ll pay costs including premiums, deductibles, coinsurance, and copayments.
- Medigap Costs: You’ll pay additional premiums for Supplement Plans (Medigap).
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