Medicare Part B Explained: Coverage, Premiums, and Deductibles for 2026
Medicare Part B covers doctor visits, outpatient care, and preventive services. Learn what Part B covers, 2026 costs, and how IRMAA affects your premium.
Medicare Part B is medical insurance. It covers doctor visits, outpatient care, preventive services, and durable medical equipment. Part B works alongside Part A to form Original Medicare.
Unlike Part A, most people pay a monthly premium for Part B. The standard premium for 2026 is $185 per month. Higher earners pay more due to income-related surcharges. This guide explains what Part B covers, what it costs, and how to enroll.
What Does Medicare Part B Cover?
Part B covers medically necessary services to diagnose or treat a medical condition. It also covers preventive services to keep you healthy. Here is what Part B includes.
Doctor Visits and Outpatient Care
Part B covers visits to your doctor or specialist. This includes office visits, consultations, and second opinions. It also covers outpatient services such as lab tests, X-rays, and minor surgeries performed in a clinic or outpatient facility.
If you are under observation status in a hospital, Part B covers your care instead of Part A. Always ask your doctor or hospital whether you are admitted as an inpatient or under observation.
Preventive Services
Part B covers many preventive services at no cost to you. You do not pay a deductible or coinsurance for these services. Preventive care helps find health problems early when they are easier to treat.
Covered preventive services include the following.
- Annual wellness visits
- Flu shots and other vaccines
- Mammograms and Pap tests
- Colonoscopy screenings
- Diabetes screenings and supplies
- Cardiovascular and bone mass screenings
Durable Medical Equipment
Part B covers durable medical equipment prescribed by your doctor. This includes wheelchairs, walkers, hospital beds, oxygen equipment, and blood sugar monitors. The equipment must be medically necessary and able to withstand repeated use.
You pay 20% of the Medicare-approved amount after you meet your deductible. Some suppliers rent equipment instead of selling it. Make sure your supplier accepts Medicare assignment to avoid higher costs.
Mental Health Services
Part B covers outpatient mental health care, including counseling and therapy. You can see a psychiatrist, psychologist, clinical social worker, or other qualified provider. Part B covers individual and group therapy sessions.
You pay 20% of the Medicare-approved amount for mental health services. If you need inpatient mental health care, Part A covers it instead.
Limited Prescription Drug Coverage
Part B covers a limited list of prescription drugs. These are usually drugs administered by a doctor or in a medical setting. Examples include chemotherapy drugs, injections given in a doctor's office, and some vaccines.
Part B does not cover most prescription drugs you pick up at a pharmacy. For those, you need Medicare Part D or a Medicare Advantage plan with prescription drug coverage.
What Part B Does Not Cover
Part B does not cover all medical services. The following are not included.
- Most prescription drugs you pick up at a pharmacy
- Dental care, except for certain surgeries
- Routine vision care and eyeglasses
- Hearing aids
- Long-term care or custodial care
- Cosmetic surgery
You may need additional coverage to pay for these services. Medicare Advantage plans often include extra benefits like dental, vision, and hearing coverage.
How Much Does Part B Cost in 2026?
Standard Monthly Premium
The standard Part B premium for 2026 is $185 per month. This is the amount most people pay. Your premium is usually deducted from your Social Security check. If you do not receive Social Security, you will be billed directly.
Annual Deductible
The Part B deductible for 2026 is $240. You must pay this amount out of pocket before Medicare starts covering your Part B services. The deductible resets every January 1.
Coinsurance
After you meet your deductible, you pay 20% of the Medicare-approved amount for most Part B services. Medicare pays the remaining 80%. This is known as the 80/20 rule.
There is no yearly limit on how much you can pay in coinsurance. If you have major medical expenses, your 20% share can add up quickly. Many people buy a Medigap plan or switch to Medicare Advantage to limit their out-of-pocket costs.
IRMAA: Income-Related Monthly Adjustment Amount
If your income is above a certain level, you will pay more for Part B due to IRMAA. IRMAA is an extra charge added to your standard premium. It is based on your modified adjusted gross income from two years ago.
For 2026, IRMAA applies if your 2024 income was above $106,000 for individuals or $212,000 for married couples filing jointly. The higher your income, the more you pay. High earners can pay up to $628.90 per month for Part B.
If you had a life-changing event like retirement, marriage, divorce, or loss of income, you can request a redetermination to lower your IRMAA. Contact Social Security for more information.
How to Enroll in Medicare Part B
Automatic Enrollment
If you are already receiving Social Security or Railroad Retirement Board benefits, you will be automatically enrolled in Part B when you turn 65. You will receive your Medicare card in the mail about three months before your birthday.
If you do not want Part B, you can decline it by following the instructions that come with your card. You should only decline Part B if you have other creditable health coverage, such as insurance through a current employer.
Manual Enrollment
If you are not receiving Social Security benefits, you must sign up for Part B during your Initial Enrollment Period. This period lasts seven months. It begins three months before the month you turn 65, includes your birthday month, and ends three months after.
You can enroll online at the Social Security website, by phone, or at a local Social Security office. If you miss your Initial Enrollment Period and do not qualify for a Special Enrollment Period, you must wait until the General Enrollment Period from January 1 to March 31 each year. Coverage starts July 1, and you may owe a late enrollment penalty.
Delaying Part B Without a Penalty
You can delay Part B enrollment without a penalty if you have health coverage through your or your spouse's current employer. The employer must have 20 or more employees. COBRA and retiree plans do not count.
You have eight months after your employment or coverage ends to sign up for Part B, whichever happens first. If you miss this window, you will owe a late enrollment penalty.
Key Takeaways
Medicare Part B covers doctor visits, outpatient care, preventive services, and durable medical equipment. The standard premium for 2026 is $185 per month, with higher amounts for high earners due to IRMAA.
After you meet the $240 deductible, you pay 20% of the Medicare-approved amount for most services. There is no yearly limit on your out-of-pocket costs, so consider adding a Medigap or Medicare Advantage plan for extra protection.
If you have employer coverage, you can delay Part B without penalty. Otherwise, enroll during your Initial Enrollment Period to avoid late enrollment penalties and gaps in coverage.
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Frequently Asked Questions
How much is the Medicare Part B premium for 2026?
The standard Medicare Part B premium for 2026 is $185 per month. If your income is above certain thresholds, you may pay more due to IRMAA. High earners can pay up to $628.90 per month depending on their modified adjusted gross income.
What is the Part B deductible for 2026?
The Part B deductible for 2026 is $240. You must pay this amount out of pocket before Medicare starts covering Part B services. After you meet the deductible, Medicare pays 80% of the approved amount for most services.
Does Part B cover prescription drugs?
Part B covers a limited list of prescription drugs, mainly those given by a doctor or administered in a medical setting, such as chemotherapy, injections, and certain vaccines. For retail prescription drugs, you need Medicare Part D or a Medicare Advantage plan with drug coverage.
What preventive services does Part B cover?
Part B covers many preventive services at no cost, including annual wellness visits, flu shots, mammograms, colonoscopies, diabetes screenings, and cardiovascular screenings. These services help detect health problems early and are fully covered with no deductible or coinsurance.
Can I delay Part B if I have employer coverage?
Yes. If you have health insurance through your or your spouse's current employer with 20 or more employees, you can delay Part B without penalty. You must enroll within eight months of losing that coverage or leaving your job, whichever comes first.
How does the 80/20 rule work with Part B?
After you meet your Part B deductible, Medicare pays 80% of the approved amount for most services. You are responsible for the remaining 20% as coinsurance. There is no yearly limit on this 20%, which is why many people buy Medigap or Medicare Advantage plans.
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