What Part B covers
Medicare Part B covers medically necessary services and preventive care. This includes:
- Doctor and specialist visits — Office visits, second opinions, and referrals.
- Outpatient care — Surgery, lab tests, X-rays, MRIs, and other diagnostic services you receive without being admitted to a hospital.
- Preventive services — Annual wellness visits, flu shots, screenings for cancer, diabetes, cardiovascular disease, and depression. Many preventive services are covered at no cost to you.
- Ambulance services — When medically necessary ground, air, or water transportation.
- Durable medical equipment (DME) — Wheelchairs, walkers, hospital beds, oxygen equipment, and diabetic supplies.
- Mental health services — Outpatient mental health care, including visits with psychiatrists, psychologists, and clinical social workers.
- Home health services — Medically necessary part-time skilled nursing, physical therapy, and other services.
- Clinical research — Certain costs of participating in approved clinical trials.
Preventive services at no cost to you: Medicare covers many screenings and vaccines at no cost when you see a provider who accepts assignment. These include mammograms, colonoscopies, flu and pneumonia shots, cardiovascular screenings, and your annual wellness visit.
Part B costs in 2026
Unlike Part A, nearly everyone pays a monthly premium for Part B. The standard premium is set each year by CMS.
| Cost | 2026 Amount |
|---|---|
| Standard monthly premium | $202.90 |
| Annual deductible | $283 |
| Coinsurance (after deductible) | 20% |
After you pay the annual deductible, you typically pay 20% of the Medicare-approved amount for most services. There is no out-of-pocket maximum with Original Medicare Part B, which is why many people add a Medigap policy.
Higher-income surcharges (IRMAA)
If your modified adjusted gross income is above a certain threshold, you'll pay more for Part B. This is called the Income-Related Monthly Adjustment Amount (IRMAA).
| Individual Income | Married Filing Jointly | Monthly Premium |
|---|---|---|
| $109,000 or less | $218,000 or less | $202.90 |
| $109,001 – $137,000 | $218,001 – $274,000 | $284.10 |
| $137,001 – $171,000 | $274,001 – $342,000 | $405.80 |
| $171,001 – $205,000 | $342,001 – $410,000 | $527.50 |
| $205,001 – $500,000 | $410,001 – $750,000 | $649.20 |
| Above $500,000 | Above $750,000 | $689.90 |
Life change? If your income has dropped due to retirement, divorce, death of a spouse, or other life-changing events, you can request that Social Security use a more recent tax return to determine your premium. File SSA-44 to request a reduction.
Late enrollment penalty
If you don't sign up for Part B when you're first eligible and don't have other creditable coverage (like employer insurance), you may pay a late enrollment penalty for as long as you have Part B.
The penalty is an additional 10% of the standard premium for each full 12-month period you could have had Part B but didn't sign up. This penalty never goes away.
Example: If you wait 3 years to enroll, your monthly premium would be 30% higher than the standard premium — for life. In 2026, that would mean paying about $264/month instead of $202.90/month.
What Part B doesn't cover
- Most dental care, including cleanings, fillings, and dentures
- Most vision care, including routine eye exams and glasses
- Hearing aids and exams for fitting them
- Long-term care (custodial care)
- Cosmetic surgery
- Most care outside the United States
- Routine foot care
Many of these gaps can be filled by a Medicare Advantage plan or through separate dental, vision, and hearing policies.
Frequently asked questions
What is the Medicare Part B premium for 2026?
The standard Part B premium for 2026 is $202.90 per month. Higher-income beneficiaries pay more through IRMAA surcharges.
What is the Part B deductible for 2026?
The Part B annual deductible for 2026 is $283. After meeting the deductible, you typically pay 20% coinsurance.
What is the Part B late enrollment penalty?
If you don't sign up for Part B when first eligible and lack creditable coverage, you pay an additional 10% of the standard premium for each full 12-month period you delayed. This penalty is permanent.
