The Medicare Part B premium
Part B is the part almost every Medicare beneficiary pays a monthly premium for. The standard amount, the income surcharge, and the hold-harmless protection are what make people's bills look different from each other.
The short version
Most people pay the standard Part B premium CMS sets each year. Higher-income enrollees pay more through IRMAA. Some long-time enrollees pay slightly less under "hold harmless" rules that prevent Social Security benefits from dropping when premiums rise. Medicare Savings Programs can pay the premium entirely.
How the standard premium is set
CMS sets the standard Part B premium each fall for the following year, based on projected Part B program costs. By law, beneficiary premiums fund roughly 25% of Part B; the federal government covers the rest.
IRMAA brackets
If your MAGI from two years ago exceeds the IRMAA threshold for your filing status, you pay extra. Five tiers above the standard, each with a fixed dollar add-on. Brackets are cliffs — a dollar over the threshold moves you to the next bracket for the whole year.
Hold harmless
"Hold harmless" protects Social Security recipients from having their net Social Security benefit drop because the Part B premium increase exceeded the cost-of-living adjustment. It applies only if your Part B premium is deducted from Social Security. New enrollees, IRMAA payers, and people not on Social Security are not protected.
This is why someone who started Medicare 5 years ago might pay a slightly different premium than a new enrollee, even with the same income.
How you pay
- Deducted from Social Security benefits if you're collecting
- Quarterly bill (CMS-500) if you've delayed Social Security
- Medicare Easy Pay (auto-debit from bank) — strongly recommended
- Online bill pay at medicare.gov
Missed payments can terminate Part B. If that happens, you generally have to wait for the General Enrollment Period (Jan 1–Mar 31) to re-enroll, with coverage starting the month after enrollment and a late penalty often added.
Help paying the premium
Medicare Savings Programs pay the Part B premium for people who qualify by income. QMB also pays Part A premiums, deductibles, and coinsurance. Apply through your state Medicaid office. Many people who would qualify never apply.
Late enrollment penalty
If you delayed Part B without creditable employer coverage, the premium includes a 10% penalty for every 12 full months you went without it. This penalty is permanent and applies for the entire time you have Part B.
Frequently asked questions
- What is the standard Part B premium?
- CMS sets the standard Part B premium each fall for the following year. Everyone pays at least the standard amount unless they qualify for Extra Help or a Medicare Savings Program. Higher-income enrollees pay more under IRMAA.
- Why is my Part B premium different from my neighbor's?
- Three reasons usually: IRMAA based on income from two years ago, a 'hold harmless' protection if you have Social Security deductions, or your enrollment year's premium being grandfathered. The standard premium applies most often to people new to Medicare.
- How is the Part B premium paid?
- Most people have it deducted from Social Security benefits automatically. If you delay Social Security, Medicare bills you quarterly. Setting up Medicare Easy Pay (auto-debit) avoids missed payments and the coverage termination that follows.
- Can the Part B premium be waived?
- Yes, through Medicare Savings Programs. QMB and SLMB pay the full Part B premium for people who qualify by income. Eligibility runs through your state Medicaid office, not Social Security.
- What if I miss a Part B premium payment?
- You'll receive a grace-period bill. If you remain unpaid past the grace period (typically 90 days), Medicare can terminate Part B. Re-enrollment usually requires waiting for the General Enrollment Period and may trigger a late penalty.
See your real Part B number
Standard, IRMAA, hold-harmless, and any late penalty all stack on the same bill. We'll show you what to expect.
Educational resource. Not legal, tax, or insurance advice.