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Medicare Part B: Medical Insurance

Last reviewed: June 2026 · Reviewed by Galit Sacajiu MD, MPH

Medicare Part B is medical insurance — it covers the services you receive outside of a hospital: doctor visits, outpatient care, preventive screenings, and durable medical equipment. The standard 2026 premium is $202.90 per month.

⚠️ Part B is Optional — But Skipping Has Consequences

If you don't enroll in Part B when first eligible and don't have qualifying employer coverage, you'll pay a 10% lifetime late enrollment penalty added to your premium for every 12 months you delayed. Enroll during your Initial Enrollment Period (7-month window around your 65th birthday) to avoid this.

What Medicare Part B Covers

👨‍⚕️
Doctor services
Visits to your primary care doctor and specialists who accept Medicare.
🏥
Outpatient care
Emergency room, observation stays, and same-day surgery.
❤️
Preventive care
Annual wellness visits, flu shots, cancer screenings, diabetes prevention — often at $0 cost.
🩺
Lab tests
Blood tests, urinalysis, and other diagnostic tests.
🩻
X-rays & imaging
MRIs, CT scans, PET scans, and more.
🦽
Durable medical equipment
Wheelchairs, walkers, hospital beds for home use, oxygen equipment.
🧬
Mental health
Outpatient mental health and substance abuse treatment.
🚑
Ambulance services
Emergency and some non-emergency transport when medically necessary.

2026 Part B Costs

Cost Type2026 Amount
Standard monthly premium$202.90
Annual deductible$283
Coinsurance after deductible20% of Medicare-approved amount
Hospital outpatient copayVaries by service
Preventive services$0 (no deductible required)

💡 The 20% Problem

After meeting the $283 deductible, Part B covers 80% of Medicare-approved costs — you pay the remaining 20%. There is no cap on your 20% in Original Medicare.

For a $100,000 surgery, you could owe $20,000. A Medicare Supplement plan or Medicare Advantage plan protects you from this exposure.

Frequently Asked Questions

What does the Part B deductible cover?+

The $283 Part B deductible applies to covered medical services in a calendar year. After you meet it, Medicare pays 80% of approved costs for most services. You pay the remaining 20% with no annual cap in Original Medicare. Preventive services like annual wellness visits and most screenings are exempt from the deductible.

When does Part B start?+

Part B starts based on when you enroll. If you enroll during the first 3 months of your Initial Enrollment Period, coverage begins the first day of the month you turn 65. If you enroll later in the window, coverage starts 1 to 3 months after you sign up. If you delay Part B because of employer coverage, it starts the month after your employer coverage ends.

Can I refuse Part B?+

Yes, but only if you have qualifying employer or union coverage from active employment. If you delay Part B and your employer coverage ends without enrolling, you will owe a lifetime late penalty of 10% per 12-month delay. If you are retired and receiving Social Security, you are automatically enrolled in Part B and must proactively decline it.

Does Part B cover physical therapy?+

Yes. Part B covers outpatient physical therapy, occupational therapy, and speech-language pathology. You pay 20% coinsurance after meeting your deductible. There is no longer a cap on the dollar amount of therapy Medicare covers, though some services require prior authorization.

What is the Part B late enrollment penalty?+

If you delay Part B enrollment without qualifying coverage, you pay an extra 10% on your monthly premium for each full 12-month period you went without coverage. This penalty is permanent and stays with you for as long as you have Part B. A 2-year delay means a 20% penalty added to your premium for life.

IRMAA: Higher Earners Pay More

If your income exceeds certain thresholds, you pay an Income-Related Monthly Adjustment Amount (IRMAA) on top of the standard premium. IRMAA is based on your income from 2 years ago.

Individual IncomeJoint IncomeMonthly Premium
≤ $106,000≤ $212,000$202.90
$106,001–$133,000$212,001–$266,000$285.90
$133,001–$167,000$266,001–$334,000$374.20
$167,001–$200,000$334,001–$400,000$459.40
$200,001–$500,000$400,001–$750,000$544.60
> $500,000> $750,000$594.10