Understanding Medicare Part B: Premiums, Deductibles, and What's Covered
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Key Takeaways
- Part B premium is $202.90/month in 2026, with a $283 annual deductible
- Covers doctor visits, outpatient services, and preventive care with 20% coinsurance after deductible
- Income-related adjustments (IRMAA) may increase premiums for higher earners
Medicare Part B is medical insurance covering outpatient care, doctor visits, and preventive services. Understanding its costs and coverage is essential for managing healthcare expenses. The 2026 premium, deductible, and coinsurance amounts differ from previous years, affecting what beneficiaries pay out of pocket.
What Is Medicare Part B?
Part B covers medically necessary outpatient services including doctor appointments, diagnostic tests, durable medical equipment, and mental health services. It's optional but recommended for most beneficiaries. Part B works alongside Part A (hospital insurance) to provide comprehensive coverage.
2026 Costs and Premiums
The standard Part B premium for 2026 is $202.90 per month. However, if your modified adjusted gross income exceeds $97,000 (individual) or $194,000 (married filing jointly), you'll pay higher income-related monthly adjustment amounts (IRMAA). Most beneficiaries pay the standard premium through automatic Social Security deductions.
| Cost Type | 2026 Amount |
|---|---|
| Monthly Premium | $202.90 |
| Annual Deductible | $283 |
| Coinsurance | 20% after deductible |
| Part B Maximum (no limit) | Varies by service |
What Part B Covers
Physician services and office visits
Preventive care (cancer screenings, vaccinations, wellness exams)
Diagnostic tests and lab work
Outpatient hospital services
Durable medical equipment (wheelchairs, oxygen)
Mental health and therapy services
Ambulance services
Coverage Gaps and Limitations
Part B does not cover routine eye exams, dental care, hearing aids, or long-term care. Prescription drugs require Part D coverage. Many beneficiaries purchase Medigap or Medicare Advantage plans to fill gaps and reduce out-of-pocket costs beyond the deductible and coinsurance.
Did You Know?
Once you meet your $283 deductible, you pay 20% of the Medicare-approved amount for most services. Medicare covers the remaining 80%. There's no annual out-of-pocket maximum under Original Medicare.
Enrollment and Changes
Most people enroll in Part B when turning 65 during their Initial Enrollment Period. Late enrollment penalties apply if you delay without qualifying exemptions. You can change plans during the Open Enrollment Period (October 15, December 7) each year.
Frequently Asked Questions
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