Plan B premiums vary by income and the year you first enrolled in Medicare

Medicare Plan B (also called Part B) is the portion of Medicare that covers doctor visits, outpatient care, and certain tests and equipment. The monthly premium you pay depends on your income from two years ago and when you first became may be able to access for Medicare. If you receive SSDI, you are automatically enrolled in Medicare after 24 months on the program, and Plan B is included in that enrollment.

The standard Plan B premium in 2024 is $164.90 per month for most people. However, if your income is higher, you pay an additional amount called an Income-Related Monthly Adjustment Amount (IRMAA). This means your actual bill could be anywhere from $164.90 to over $560 per month, depending on your specific income level.

Your premium is deducted directly from your SSDI payment each month, so you do not receive a separate bill. If your income changes significantly, you can request that Social Security recalculate your IRMAA, though this process takes time and has specific rules about what counts as a may have access to change.

Key Takeaways

  • The standard Plan B premium for 2024 is $164.90 per month, but you may pay more if your income from two years ago exceeded certain thresholds.
  • Your premium is automatically deducted from your SSDI check, so you do not need to pay a separate bill or make a separate payment arrangement.
  • Income thresholds that trigger higher premiums change each year, and the income used to calculate your premium is from your tax return from two years prior.
  • You can request a recalculation of your IRMAA if you experience a major life change like job loss, divorce, or death of a spouse, but you must submit the request within 60 days of the event.
  • Plan B has an annual deductible (currently $240 in 2024) that you must pay out of pocket before Medicare begins to cover your doctor visits.

How income affects your Plan B premium

Medicare uses your Modified Adjusted Gross Income (MAGI) from your federal tax return from two years before the current year to determine your IRMAA. For example, in 2024, Medicare looks at your 2022 tax return. This means if you had high income in 2022 but your situation has changed, you may still pay a higher premium in 2024 until the system catches up.

The income thresholds are different for single filers and married couples filing jointly. In 2024, for example, a single person with MAGI over $103,000 begins paying an additional amount on top of the standard premium. A married couple filing jointly with MAGI over $206,000 faces the same surcharge. These thresholds increase slightly each year.

If your income drops significantly—such as through job loss, retirement, or a major reduction in work hours—you can request that Social Security recalculate your IRMAA using your current year's income instead. This request must be made within 60 days of the event that caused the income change, and you will need to provide documentation of the change.

What Plan B actually covers

Plan B covers doctor office visits, preventive care like screenings and vaccines, emergency room visits, and outpatient surgery. It also covers certain diagnostic tests, mental health services, and physical therapy. However, Plan B does not cover prescription drugs—that is covered under Plan D, which is a separate enrollment and premium.

You pay a 20 percent coinsurance for most Plan B services after you meet your annual deductible. The deductible for 2024 is $240, meaning you pay the full cost of services until you have spent $240 out of pocket in a calendar year. After that, Medicare covers 80 percent and you pay 20 percent.

Some services, like preventive care, have no coinsurance—Medicare covers them fully once you have met your deductible. Your doctor's office can tell you whether a specific visit or test is considered preventive under Medicare rules.

When your premium starts and how it changes

If you receive SSDI, you are automatically enrolled in Medicare Part A (hospital insurance) and Plan B (doctor insurance) after you have been on SSDI for 24 months. Your Plan B premium begins the month after your may be able to access starts. You do not need to do anything to enroll—it happens automatically.

Your premium amount can change each year, typically in January. Medicare recalculates IRMAA annually based on the income threshold changes set by the federal government. If your income situation has not changed, your premium may still increase slightly due to cost-of-living adjustments.

If you believe your premium is calculated incorrectly, you can contact Social Security to request a review. You will need to provide documentation of your actual income, such as recent tax returns or pay stubs. The review process typically takes several weeks.

Plan B costs beyond the monthly premium

The monthly premium is only one cost of Plan B. You also pay an annual deductible ($240 in 2024), and then 20 percent coinsurance for most services. If you see multiple doctors or have ongoing treatment, these out-of-pocket costs can add up quickly.

Some people with SSDI income also have Medicaid through their state, which can help pay Plan B premiums and cover some of the coinsurance and deductible amounts. Whether you may have access to for Medicaid depends on your state's rules and your income level. You can contact your state Medicaid office to learn whether you may be covered.

If your out-of-pocket costs become very high, you may be able to get help through a program called Medicare Savings Programs (MSP). These state-run programs help pay Medicare premiums, deductibles, and coinsurance for people with limited income. Each state runs its own program with different income limits, so you will need to check with your state to see whether you may have access to.

What happens if you cannot afford your Plan B premium

If your Plan B premium is deducted from your SSDI check and you cannot afford it, you have limited options. You cannot straightforward stop paying the premium—it will continue to be deducted automatically. However, you can request a recalculation if your income has dropped due to a may have access to life event.

If you are struggling to pay for medical care, talk to your doctor's office about payment plans or sliding scale fees. Many community health centers offer services on a sliding fee scale based on income. You can also call 211 to find local resources that may help with medical costs.

Some states offer additional help programs for people on SSDI. Contact your state's Medicaid office or your local Area Agency on Aging to learn what programs may be available in your area.

Frequently Asked Questions

Can I decline Plan B and keep only Plan A?

You can decline Plan B when you first become may be able to access for Medicare, but if you do not enroll when you are first may be able to access and later want to join, you will pay a permanent penalty on top of your regular premium. The penalty is 10 percent of the standard premium for each year you were may be able to access but did not enroll. Most people should enroll when first may be able to access to avoid this penalty.

Does my Plan B premium change if I go back to work?

Your premium is based on your income from two years ago, so if you return to work in 2024, your premium will not change until 2026 (when 2024 income is used for calculation). However, if your work income is substantial, your premium will increase significantly once the new income is factored in. You can request a recalculation if you experience a major drop in income.

What if I have both SSDI and a job—how is my income calculated?

Your MAGI includes all income sources: SSDI, wages, self-employment income, interest, dividends, and other sources. If you work while receiving SSDI, your total income from all sources is what determines your Plan B premium. Some work income may be excluded under SSDI work incentive rules, but Medicare uses your actual tax return, which includes all reported income.

Can I switch to a different Medicare plan if Plan B is too expensive?

You can switch to a Medicare Advantage plan (Part C) during the annual enrollment period (October 15 to December 7 each year). Some Medicare Advantage plans have lower or no premiums, though they typically have higher out-of-pocket costs when you use services. You would still be enrolled in Plan B, but the Advantage plan would coordinate with it.

What if my state offers Medicaid—will that help pay my Plan B premium?

If you may have access to for both Medicare and Medicaid (called "dual may be able to access"), Medicaid can help pay your Plan B premium and cover some coinsurance and deductibles. However, Medicaid rules vary by state, and not all states cover the same services. Contact your state Medicaid office to learn what help may be available to you.