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
2026 Part B Costs
| Cost Type | 2026 Amount |
|---|---|
| Standard monthly premium | $202.90 |
| Annual deductible | $283 |
| Coinsurance after deductible | 20% of Medicare-approved amount |
| Hospital outpatient copay | Varies 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 Income | Joint Income | Monthly 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 |