How Medicare Part B Cost Sharing Works
You will pay the Medicare Part B premium and share part of costs with Medicare for covered Part B health care services. Medicare Part B pays 80% of the cost for most outpatient care and services, and you pay 20%.
For 2023, the standard monthly Part B premium is $164.90. You'll pay the standard amount if:
- You enroll for the first time in 2023.
- You aren't receiving Social Security benefits.
- Your premiums are billed directly to you.
- You have Medicare and Medicaid, and Medicaid pays your premiums.
Your Part B premium may be less than the standard amount if you enrolled in Part B in 2021 or earlier and your premium payments are deducted from your Social Security check.
Your premium may be more than the standard amount based on your income. You will pay an income‑related monthly adjustment amount (IRMAA) if your reported income was above $97,000 for individuals or $194,000 for couples in 2021. Visit Medicare.gov to learn more about IRMAA.
And while Medicare will share your Part B health care costs with you, there is something called "Medicare assignment" that's important to understand.
Doctors and providers who accept Medicare assignment agree to take what Medicare pays—the Medicare-approved amount—as payment in full. Medicare reduces the approved amount it pays for doctors who don't accept Medicare assignment. Doctors who don't accept Medicare assignment may charge more than the Medicare-approved amount. You may have to pay the additional cost, which is called "excess charges."