The standard Medicare Part B premium for 2025 is $185.00 per month, with an annual deductible of $257. But the total you pay depends on your income, when you enrolled, and what services you use. Here’s a full breakdown of every cost tied to Part B.
The Standard Monthly Premium
Most people pay the standard $185.00 per month for Part B in 2025. This premium is typically deducted automatically from your Social Security check. If your Social Security payment isn’t large enough to cover it, or you don’t receive Social Security yet, you’ll get a separate bill from the federal government.
For 2026, the standard premium rises to $202.90 per month, an increase of $17.90. The annual deductible also goes up to $283, a $26 jump from 2025. CMS attributes the increase to projected price changes and utilization trends consistent with historical patterns.
Income-Based Surcharges (IRMAA)
If your income exceeds certain thresholds, you’ll pay more than the standard premium. Medicare calls this the Income-Related Monthly Adjustment Amount, or IRMAA. The surcharge is based on your modified adjusted gross income from two years prior, so your 2023 tax return determines your 2025 premium.
For individuals filing single returns in 2025:
- $106,000 or less: $185.00 (standard premium, no surcharge)
- $106,001 to $133,000: $259.00
- $133,001 to $167,000: $370.00
- $167,001 to $200,000: $480.90
- $200,001 to $499,999: $591.90
- $500,000 or more: $628.90
For married couples filing jointly, the income thresholds are roughly doubled. A couple earning $212,000 or less pays the standard $185.00. Above that, premiums step up through the same tiers, topping out at $628.90 per person for joint income of $750,000 or more.
Married people who file separately face a much steeper jump. If you lived with your spouse at any time during the year and file separately, any income above $106,000 pushes your premium to $591.90 per month. At $394,000 and above, it reaches the maximum $628.90.
If your income has dropped significantly since the tax year Medicare is using (due to retirement, divorce, death of a spouse, or other life-changing events), you can ask Social Security to reconsider using a more recent year’s income.
The Annual Deductible and Coinsurance
Before Part B starts paying for most services, you need to meet the $257 annual deductible in 2025. After that, the standard split is 80/20: Medicare pays 80% of the approved amount, and you pay the remaining 20% as coinsurance. This applies to doctor visits, outpatient procedures, durable medical equipment, and most other Part B services, as long as your provider accepts Medicare assignment (meaning they agree to accept Medicare’s approved amount as full payment).
Several categories of care skip the deductible and coinsurance entirely. Clinical lab services like bloodwork are covered at 100%. Home health care services carry no cost-sharing. Annual depression screenings and many other preventive services, including flu shots, colorectal cancer screenings for adults 45 to 75, cholesterol checks, diabetes screenings, lung cancer screenings for high-risk adults, and obesity counseling, are all covered at zero cost to you. Annual wellness visits also have no deductible or coinsurance.
Outpatient hospital services work a bit differently. You’ll typically owe a copayment to the hospital for each service, which can vary by facility and procedure.
What Part B Does Not Cover
Part B has notable gaps. It does not cover most dental care, including cleanings, fillings, extractions, and dentures. Routine eye exams for eyeglasses and hearing aids (along with the exams to fit them) are excluded. Long-term care, cosmetic surgery, massage therapy, and routine physicals are also not covered. If your doctor has opted out of Medicare entirely, Medicare won’t pay for their services except in emergencies.
Many people fill these gaps with a Medicare Supplement (Medigap) plan, a Medicare Advantage plan, or separate dental and vision insurance.
Late Enrollment Penalties
If you don’t sign up for Part B when you’re first eligible and don’t have qualifying coverage through an employer, you’ll face a permanent penalty. The math is straightforward: your premium goes up 10% for every full 12-month period you could have had Part B but didn’t. So if you delayed enrollment by three years, you’d pay a 30% surcharge on top of the standard premium for as long as you have Part B. For most people, that means the rest of their life.
This penalty is separate from IRMAA surcharges and stacks on top of whatever premium tier you fall into. It’s one of the most expensive mistakes in the Medicare system, because it never goes away.
Help Paying Part B Costs
If your income and assets are low enough, Medicare Savings Programs can cover some or all of your Part B expenses. There are three main tiers, each with its own income limits (listed here using 2026 federal figures):
- Qualified Medicare Beneficiary (QMB): Covers your Part B premium, deductible, and coinsurance. Individual income limit of $1,350 per month with resources up to $9,950. For married couples, $1,824 per month with $14,910 in resources.
- Specified Low-Income Medicare Beneficiary (SLMB): Covers the Part B premium only. Individual income limit of $1,616 per month, same resource limits as QMB.
- Qualifying Individual (QI): Also covers the Part B premium. Individual income up to $1,816 per month, same resource limits.
Limits are slightly higher in Alaska and Hawaii, and some states set their own thresholds above the federal minimums. You apply through your state Medicaid office. These programs can save you over $2,200 per year in premiums alone, and QMB can save substantially more by eliminating your coinsurance and deductible too.
Total Annual Cost at a Glance
For someone paying the standard premium in 2025, the baseline annual cost of Part B breaks down to $2,220 in premiums plus the $257 deductible, totaling $2,477 before any coinsurance kicks in. Your actual spending beyond that depends entirely on how much care you use, since you’re responsible for 20% of approved charges after the deductible. There’s no out-of-pocket maximum built into Original Medicare, which is why many beneficiaries add supplemental coverage to cap their exposure.
At the highest IRMAA tier, premiums alone reach $7,546.80 per year. Even at the first surcharge level, you’re paying $3,108 annually in premiums, nearly $900 more than the standard rate.