The truth about your Medicare Part B premium

You probably know that your Medicare Part B premium can change each year. Do you know why? Or how the amount is calculated? Or why it may increase?

Medicare costs, including Part B premiums, deductibles and copays, are adjusted based on the Social Security Act. And in recent years Part B costs have risen. Why? According to CMS.gov, “The increase in the Part B premiums and deductible is largely due to rising spending on physician-administered drugs. These higher costs have a ripple effect and result in higher Part B premiums and deductible.”¹

The standard Part B premium for 2024 is $174.70 to $594.00 per month depending on your income. However, some people may pay less than this amount because of the “hold harmless” rule. The rule states that the Part B premium may not increase more than the Social Security Cost of Living Adjustment (COLA) increase in any given year. In short, this provision prevents your Social Security checks from declining year-over-year and caps Medicare Part B premium increases to be no more than the amount of your COLA.²

For people who are not “held harmless” the Part B premiums can increase as much as necessary until the standard rate is reached for the given year. You will have to pay this increased amount if any one of the following applies to you:

• You are new to Medicare
• You don’t get Social Security benefits
• You pay higher premiums due to having a higher income

Additionally, people with higher incomes may pay more than the standard Part B premium amount due to an “income-related monthly adjustment.” The adjustment is based on adjusted gross income reported 2 years prior.

The table below shows 2024 Part B premium amounts. Look for your tax filing status, individual or joint, and find your 2022 income in that column. Follow the row across to see what you will pay for Part B in 2024.³

Your Part B premium amount will be deducted from your monthly Social Security, Railroad Retirement Board or Civil Service benefit payment if you receive one of these. If you don’t receive any of these benefits, you’ll need to pay for Part B directly. In this case, Medicare will send you a bill for Part B coverage called the Medicare Premium Bill.

You may request an appeal if you disagree with a decision regarding your income-related monthly adjustment amount. Complete a Request for Reconsideration (Form SSA-561-U2) or contact your local Social Security office to file an appeal.

You may be able to skip the formal appeal and simply provide documentation if your income changed due to any of the following:

• You married, divorced or became widowed.
• You or your spouse stopped working or reduced your work hours.
• You or your spouse lost income-producing property due to a disaster or other event beyond your control.
• You or your spouse experienced a scheduled cessation, termination or reorganization of an employer’s pension plan.
• You or your spouse received a settlement from an employer or former employer because of the employer’s closure, bankruptcy or reorganization.

These methods apply to the Part B premium. Contact the IRS if you disagree with your adjusted gross income amount, which is provided to Medicare by the IRS.

The Part B premium is calculated every year. You may see a change in the amount of your Social Security checks or in the premium bills you receive from Medicare. Check the amount you’re being charged and follow up with Medicare or the IRS if you have questions.