Medicare/Part B
Medicare Part B · Medical Insurance
Doctor visits, outpatient care, and preventive services.
Part B is the medical side of Original Medicare. The 2025 standard premium is $185/month — but higher earners pay more via IRMAA.
$185
standard monthly premium 2025
Premium by income (IRMAA)
What you pay for Part B in 2025
Your Part B premium is based on your income from two years ago. Most people pay the standard $185/month — but higher earners pay more.
| 2025 Individual MAGI (from 2023 taxes) | 2025 Monthly Part B Premium★ popular |
|---|---|
| ≤ $106,000 | $185.00 |
| $106,001 – $133,000 | $259.00 |
| $133,001 – $167,000 | $370.00 |
| $167,001 – $200,000 | $480.90 |
| $200,001 – $500,000 | $591.90 |
| Above $500,000 | $628.90 |
Married-filing-jointly thresholds are double the individual limits above. Source: CMS 2025. IRMAA amounts also apply to Part D — ask your advisor for the combined surcharge.
Don't miss your window — the late-enrollment penalty is permanent
If you delay Part B without qualifying employer coverage, your premium increases by 10% for each full 12-month period you went without it — and that surcharge is added to your bill every month for the rest of your enrollment. A 2-year delay means a 20% surcharge forever. Enroll during your Initial Enrollment Period (IEP) unless you have a valid reason to delay.
See the Turning 65 guide →What's covered
Outpatient, preventive, and more
Part B covers two types of services: medically necessary and preventive.
Medically necessary services
Services your doctor orders
Part B pays 80% of covered medically necessary services after your annual deductible ($257 in 2025). You pay the remaining 20% — unless you have Medigap.
- Doctor and specialist visits (primary care, surgeons, psychiatrists)
- Outpatient surgery and hospital services
- Lab tests, X-rays, MRIs, and CT scans
- Ambulance services
- Durable medical equipment (wheelchairs, CPAP, walkers)
- Outpatient mental health and substance use counseling
Preventive services
Annual screenings and wellness visits — at no cost
Part B covers a wide range of preventive services at $0 when you use a participating provider. These are fully covered — no deductible, no coinsurance.
- Annual Wellness Visit (AWV) — yearly health assessment
- Mammograms, colorectal cancer screenings, and Pap smears
- Bone density scans (DEXA) for osteoporosis
- Diabetes screenings and cardiovascular risk tests
- Flu, Pneumonia, and COVID-19 vaccines
- Tobacco cessation counseling
FAQ
Part B questions
What is the standard Part B premium in 2025?+
The standard Part B premium is $185.00/month in 2025. Higher-income beneficiaries pay more via IRMAA (Income-Related Monthly Adjustment Amount). If your income is above $103,000 (individual) or $206,000 (married filing jointly), you pay a surcharge on top of $185.
What is IRMAA?+
IRMAA is the Income-Related Monthly Adjustment Amount — a surcharge added to your Part B (and Part D) premium if your modified adjusted gross income from two years ago exceeds certain thresholds. Social Security calculates IRMAA based on your most recent tax return. You can appeal if your income has dropped due to a life event.
What is the Part B late-enrollment penalty?+
If you don't enroll in Part B when first eligible and you don't have qualifying coverage, your premium increases 10% for each 12-month period you delayed. The penalty is permanent — it's added to your premium every month for as long as you have Part B.
What does Part B cover?+
Part B covers medically necessary doctor and outpatient services: visits to physicians, surgeons, and specialists; outpatient surgery and hospital services; lab work and diagnostic imaging; ambulance services; durable medical equipment (wheelchairs, walkers, CPAP machines); and annual wellness visits and preventive screenings (which are covered at no cost if you use a participating provider).
Does Part B cover mental health care?+
Yes. Part B covers outpatient mental health services including psychotherapy, psychiatric evaluations, and outpatient substance use disorder counseling. You typically pay 20% coinsurance after the deductible.
How does Part B work with Medigap?+
After you meet your Part B deductible ($257 in 2025), Medicare pays 80% of covered outpatient services. A Medigap plan like Plan G pays your 20% coinsurance, leaving you with little to no out-of-pocket cost.
Can I delay Part B if I'm still working in NJ?+
Yes — if you're 65+ and covered by an employer group plan from a company with 20+ employees, you can delay Part B without penalty. When you (or your spouse) retire or lose that coverage, you have an 8-month Special Enrollment Period to enroll. Small-employer plans (fewer than 20 employees) require Part B as primary at 65, so delaying is risky.
How do I appeal an IRMAA surcharge in NJ?+
NJ residents who have had a qualifying life-changing event — retirement, divorce, death of spouse, or significant reduction in income — can file form SSA-44 to ask Social Security to recalculate IRMAA using current income rather than the two-year-old tax return. This can substantially lower your monthly Part B premium.
Questions about Part B or IRMAA?
A licensed NJ advisor can explain your premium, help you appeal an IRMAA decision, and find the right supplemental coverage — no cost.