Q: How much does Medicare Part B cost the insured?
A: In 2019, most people earning no more than $85,000 ($170,000 for a married couple) pay $135.50/month for Part B — an increase from about $130/month in 2018. And in most cases, Part B premiums are just deducted from beneficaries’ Social Security checks.
In 2019, most enrollees are paying the full $135.50 premium. That’s in contrast with 2017 and 2018, when most enrollees paid a premium that was lower than the standard premium. The standard premium in 2018 was actually $134/month, but the cost of living adjustment for Social Security wasn’t quite large enough to cover all of the increase from 2017’s premium for most enrollees, which is why most people paid about $130/month.
But some enrollees were paying $134/month instead in 2018. That included people who were new to Medicare in 2018, as well as those who were new to Medicare in 2017, when the standard premium was also $134/month. In addition, people who weren’t receiving Social Security checks were paying $134/month for their Part B coverage in 2018. This included people who will eventually receive Social Security but hadn’t started receiving it as of 2018, as well as those who paid into a different retirement system and will never receive Social Security. They pay Medicare Part B premiums directly (since there’s no Social Security check from which they can be deducted), so they always pay the standard amount (assuming they don’t have income high enough to be subject to the high-income premiums), with no protection from higher rates based on Social Security cost-of-living adjustments.
People who earn more than $85,000 ($170,000 for a couple) pay higher Part B premiums based on their income, with premiums that range from $189.60/month to $460.50/month in 2019. The government bases this on your income tax return from two years ago, since that will be the most recent tax return they have on file at the start of the plan year (eg. 2018 tax returns were filed in 2019, so those will be the most current returns available when income-related premium adjustments are made for 2020). But if a life-change event has subsequently reduced your income, there’s an appeals process you can use to request that the income-related premium adjustment be changed or eliminated without having to wait for it to reflect on a future tax return.
Medicare B also has a deductible, which is $185 in 2019 (a $2 increase from 2018, when it was $183). After the deductible is met, the enrollee is generally responsible for 20 percent of the Medicare-approved cost for Part B services. But supplemental coverage (from an employer-sponsored plan, Medigap, or Medicaid) often covers these coinsurance charges.