
Do I Have to Pay a Premium for Medicare Part B?
Medicare Part B medical insurance helps cover doctor visits, preventive care, tests, durable medical equipment and other outpatient services. But unlike Part A, most people do have to pay a monthly premium for Part B coverage.
Medicare Part B is optional, but the premium is required if you want to enroll in Part B benefits. Very few people get Part B for free. Let's look at who has to pay a premium for Medicare Part B, how much it costs in 2023, and what factors affect the amount you'll pay.
Medicare Part B Premium Overview
Most people pay the standard premium amount set annually by Medicare
The standard Part B premium is $164.90 per month in 2023
Higher income seniors pay premiums higher than the standard amount
A penalty may apply if you don't sign up for Part B when first eligible
Very low income seniors may qualify for state assistance programs that help cover Part B premiums
Unless you have low income and qualify for assistance, expect to pay a monthly premium for Medicare Part B.
What Does Medicare Part B Cover?
Medicare Part B helps fill significant gaps in coverage left by Part A hospital insurance:
Doctor office and telehealth visits
Preventive care screenings and annual wellness visits
Lab tests, x-rays, MRI, CT scans
Durable medical equipment - wheelchairs, walkers
Ambulance transportation
Mental health services - counseling, therapy
Many Part B-covered drugs administered by a physician
Part B covers 80% of the Medicare-approved amount for these services in most cases. You need to pay the remaining 20% coinsurance.
Who Gets Medicare Part B for Free?
There are limited situations where someone may qualify to enroll in Part B without having to pay a premium:
Some seniors with age 65 with very low income and assets who qualify for state Medicaid programs that cover the Part B cost
Some disabled adults who qualify for Medicaid coverage that pays their Part B premium
People with end-stage renal disease may get Part B premium-free for the first 30 months of Medicare eligibility
Government retirees with TRICARE may have Part B fully or partly subsidized when they turn 65
Unless you meet eligibility for one of these assistance programs and sign up for Medicare, you'll need to pay the monthly Part B premium yourself.
The Medicare Part B Premium in 2023
The standard monthly premium for Medicare Part B in 2023 is $164.90 for most beneficiaries. This represents about a 3% increase from the 2022 Part B premium amount.
Annual increases to the Part B premium are tied to the Social Security cost of living adjustment (COLA). Higher COLAs generally mean larger premium jumps.
The 2023 Part B premium is significantly lower than the projected 2023 premium of $203 released by Medicare in the fall of 2022. This decrease was thanks to lower than expected spending on the Alzheimer's drug Aduhelm.
What Affects Your Medicare Part B Premiums?
Two main factors impact how much you'll pay for your individual Medicare Part B monthly premium:
1. Income
Higher income enrollees pay more than the standard premium based on their IRS-reported modified adjusted gross income (MAGI) two years prior:
Individuals with income over $97,000 and couples over $194,000 pay the standard premium plus an Income Related Monthly Adjustment Amount (IRMAA) surcharge based on a sliding scale.
For example, a single filer with $150,000 MAGI pays $297.50 per month for Part B in 2023.
2. Penalties
If you don't sign up for Part B when initially eligible and don't have other coverage, you may incur a lifetime late enrollment penalty added to your premiums when you do enroll.
The penalty is 10% for every 12 month period you delayed enrolling after initial eligibility.
If you wait 3 years to enroll, the penalty will be 30% applied to the current premium rate.
How to Pay Your Medicare Part B Premium
If you're enrolled in Social Security, your Part B premium will automatically be deducted from your monthly Social Security benefit check.
If you aren't receiving Social Security yet, Medicare will send you quarterly bills for your Part B premium. You can pay by check, money order, debit/credit card online, or having monthly payments automatically withdrawn from your bank account.
Higher income enrollees will have their increased IRMAA premiums deducted from Social Security checks or billed directly quarterly like other Part B premiums.
Part B premiums can also be deducted from your Railroad Retirement Board (RRB) benefits if you receive RRB instead of Social Security benefits.
Weighing the Value of Medicare Part B
While most Medicare enrollees must budget for the monthly cost of Part B coverage, keep in mind that this premium plus 20% coinsurance for covered services is generally much lower than what you'd pay for comparable medical care without insurance.
And having comprehensive Original Medicare coverage with both Part A and Part B prevents unexpected medical bills that could easily be thousands of dollars without coverage.
Most Medicare beneficiaries find the Part B premium is money well spent for the peace of mind and financial protection Medicare provides.
Conclusion
Unless you qualify for premium-free Part B through a Medicare Savings Program or other assistance, you should expect to budget the standard monthly premium amount, which is $164.90 per month in 2023. Weigh this required premium cost against the value of having comprehensive medical insurance and reduced out-of-pocket costs with Part B.
We’re Here to Help
You do not have to spend hours reading articles on the internet to get answers to your Medicare questions. Give the licensed insurance agents at Bourgeois Insurance a Call at (985) 803-8999. You will get the answers you seek in a matter of minutes, with no pressure and no sales pitch. We are truly here to help.
FAQS
What is Medicare Part A coverage?
Medicare Part A helps cover inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care. Part A is premium-free for most people who have worked and paid Medicare taxes for at least 10 years.
How do I enroll in Medicare Part B?
You can apply for Medicare Part B during your initial enrollment period when you're first eligible for Medicare. You can also enroll or make changes during the annual Medicare open enrollment period each year.
What does Medicare Part B help pay for?
Medicare Part B helps cover medically necessary doctor's services, outpatient care, durable medical equipment, and many preventive services. Part B requires you to pay a monthly premium.
What is the Medicare Part B premium in 2023?
The standard Medicare Part B premium in 2023 is $164.90 per month. However, some beneficiaries may pay more or less than this amount.
What is the Medicare Part B deductible?
In 2023, the Medicare Part B deductible is $226 per year. This is the amount you pay out-of-pocket before Medicare Part B coverage kicks in.
What is a Medicare Advantage Plan?
Medicare Advantage Plans or part c are an alternative to Original Medicare. These private insurance plans contract with Medicare to provide all your Part A and Part B coverage but can do so differently than Original Medicare. Many include extra benefits.
What is Medicare Part D prescription drug coverage?
Medicare Part D provides prescription drug coverage. This is optional coverage you can get through a stand-alone plan or a Medicare Advantage Plan that offers drug coverage.
What is a Medicare Supplement Insurance plan?
Medicare Supplement Insurance plans help fill gaps in Original Medicare coverage. These private plans pay part of Medicare out-of-pocket costs like deductibles and coinsurance.
What is the Medicare Part D late enrollment penalty?
If you don't sign up for a Medicare Part D Plan when first eligible, you may have to pay a late enrollment penalty if you enroll later. This penalty is added to your monthly Part D premium.
How can I get help with Medicare costs?
If you have limited income and resources, you may qualify for help through a Medicare Savings Program. These state programs can help pay for Medicare premiums, deductibles, and coinsurance.