Medicare Part B helps pay for doctor's services, outpatient care and medical equipment, and in 2026 the standard Part B premium is $202.90 a month. On top of that premium, Part B has a $283 deductible in 2026, and after it you typically pay 20% of the Medicare-approved amount, with no yearly cap in Original Medicare. Sign up at the wrong time and you can also owe a penalty that lasts as long as you have Part B.,,

In This Guide

What Is Medicare Part B?

Medicare Part B is the Medical Insurance side of Medicare. Part A and Part B together make up what's called Original Medicare.

So where does one stop and the other start? The Centers for Medicare & Medicaid Services (CMS) describes Part B as covering physicians' services, outpatient hospital services, certain home health services, durable medical equipment, and certain other medical and health services that Medicare Part A doesn't cover. In plain terms: when your mom's cardiologist visit or a piece of her medical equipment shows up on a Medicare statement, Part B is usually the part doing the paying.

What Does Medicare Part B Cover?

The Medicare & You 2026 handbook lists these as what Part B helps cover:

  • Medically necessary doctor's services
  • Outpatient care
  • Some home health services
  • Durable medical equipment
  • Mental health services
  • Limited outpatient prescription drugs
  • Other medical services
  • Many preventive services

That's a category list, not a guarantee for any single item. Medicare may also cover some services and tests more often than the timeframes it lists if they're needed to diagnose or treat a condition.

If you're trying to pin down one specific test or item, the FAQ below covers how to look it up.

How Much Does Medicare Part B Cost in 2026?

CMS set the 2026 Medicare Part B amounts in its annual premiums and deductibles fact sheet, and Medicare.gov's costs page lays out what you pay for services. Here are the 2026 numbers side by side.

Part B cost Amount in 2026 How it works
Standard monthly premium $202.90 a month Most people pay the standard amount, and it's owed every month even in a month you use no Part B services
Premium with the income-related surcharge $284.10 to $689.90 a month in total Applies if your 2024 modified adjusted gross income was above $109,000 on an individual return or $218,000 on a joint return; married people filing separately use a separate table
Annual deductible $283 Paid once each year before Part B starts paying its share
Coinsurance 20% of the Medicare-approved amount Applies after the deductible when the provider accepts assignment; you pay more with providers who don't
Hospital outpatient copayment Per service In most cases no more than the Part A hospital stay deductible
Covered clinical lab services $0 No cost for covered lab work
Most covered preventive services $0 When the provider accepts assignment
Yearly out-of-pocket limit None Original Medicare has no yearly cap

A few of those rows deserve a closer look.

The Part B premium is income-related. For 2026, Medicare looks at the modified adjusted gross income on your tax return from 2 years earlier, so someone whose 2024 income was above $109,000 (individual return) or $218,000 (joint return) may pay an extra monthly amount on top of the $202.90 standard premium. CMS says the income-related Part B premium surcharges affect roughly 8% of people with Part B. The bracket-by-bracket detail lives in Brevy's IRMAA guide, linked below.

Where the 2026 Medicare Part B deductible of $283 applies, you pay the full Medicare-approved amount for covered services until you've met it for the year.

After the deductible, Medicare pays its share and you typically pay 20% of the Medicare-approved amount for each covered Part B service or item, as long as the doctor or other provider accepts assignment. With a provider who doesn't accept assignment, you pay more. In a hospital outpatient department you also pay the hospital a copayment for each service, except certain preventive services, and in most cases that copayment won't be more than the Part A hospital stay deductible.

The $0 rows come with one caveat worth knowing before a checkup. Some preventive services can still carry a deductible, coinsurance or both, and those costs may also apply when you get a preventive service in the same visit as a non-preventive service.

What a Year of Part B Premiums Adds Up To

The monthly number is easy to shrug off. The yearly one is harder to ignore.

Why There's No Out-of-Pocket Cap

This is the part that surprises people. Original Medicare, meaning Part A and Part B, has no yearly limit on what you pay out of pocket. The 20% coinsurance you typically pay on covered Part B services keeps applying for as long as you keep getting care.

What changes that is other coverage. Medicare.gov says there may be limits with supplemental coverage such as Medigap, Medicaid, or employer, retiree or union coverage.

Medicare Advantage works differently. Medicare Advantage plans have a yearly limit on what you pay for covered Part A and Part B services, which may include different limits for in-network and out-of-network care, and once you reach your plan's limit you pay nothing for covered services for the rest of the year. By regulation, a Medicare Advantage plan's in-network limit can't be higher than the annual limit CMS calculates.

What Medicare Part B Doesn't Cover

Original Medicare (Parts A and B) excludes a handful of things families commonly assume are covered. The big one is long-term custodial care: Medicare doesn't pay for non-skilled help with bathing, dressing, eating, getting in and out of bed or using the bathroom when that's the only care someone needs, whether at home, in assisted living or in a nursing home. The exception is custodial help furnished as part of Medicare-covered hospice care.

Original Medicare also doesn't cover:

Several of those have narrow medical exceptions, and they matter for older adults. Original Medicare covers some dental services that are integral to certain covered treatments, such as an oral exam and dental treatment before a heart valve replacement or an organ transplant, or a tooth extraction to treat a mouth infection before chemotherapy. After cataract surgery that implants an intraocular lens, Part B covers one pair of standard eyeglasses or one set of contact lenses. And while Medicare doesn't cover hearing aids, it does cover diagnostic hearing and balance exams a doctor orders, and it covers cochlear implants as prosthetic devices.

Medicare Advantage plans often add routine dental, vision and hearing benefits that Original Medicare lacks, but the scope varies widely from plan to plan, so check the specific plan.

When to Sign Up for Part B, and Whether You Need It Now

Timing is where Part B gets expensive if you get it wrong, so it's worth slowing down here.

If you already get Social Security. People who start receiving Social Security benefits at least 4 months before turning 65 are enrolled in Medicare Part A and Part B automatically, and the Medicare card arrives in a welcome package about 3 months before coverage starts. People living in Puerto Rico or outside the United States get Part A automatically but have to sign up for Part B themselves.

If you don't get Social Security yet. You have to sign up through the Social Security Administration. Your Initial Enrollment Period is a 7-month window: the 3 months before the month you turn 65, the month you turn 65, and the 3 months after. If you sign up before your birthday month, Part B coverage starts the month you turn 65; sign up in your birthday month or later in the window and it starts the next month.

If you're still working with job-based coverage. This is the situation where waiting can make sense. If you have health insurance through your job or your spouse's job, a Special Enrollment Period for Part B starts the month after your Initial Enrollment Period ends and runs until 8 months after the group health plan coverage or the employment ends, whichever happens first. Signing up for Part B in that window avoids the late enrollment penalty.

Be careful with what counts. Medicare.gov is explicit that COBRA coverage or retiree coverage ending does not qualify you for a Part B Special Enrollment Period, and neither does having or losing Marketplace coverage. COBRA isn't considered group health plan coverage, and getting COBRA doesn't change when your 8-month window ends.

If you missed your window. The General Enrollment Period for Part B runs January 1 through March 31 each year, and coverage starts the month after you sign up.

The Part B late enrollment penalty

If you don't sign up for Part B during your Initial Enrollment Period and don't qualify for a Special Enrollment Period or a Medicare Savings Program, your monthly Part B premium goes up 10% for each full 12-month period you could have had Part B but didn't. The penalty lasts as long as you have Part B.

That permanence is the reason to get the timing right the first time. If you're weighing a delay because of employer coverage, the working-past-65 guide below walks through that decision in more depth.

Part B With Medicare Advantage or Medigap

Buying extra coverage doesn't replace Part B. A Medicare Advantage enrollee must have Part B and keep paying the Part B premium to stay in the plan, and a Medigap policyholder must have Part B and keep paying the Part B premium to keep the policy.

In a Medicare Advantage plan you may also pay the plan's own premium on top of the Part B premium. Some Medicare Advantage plans have a $0 premium, and some may help pay all or part of your Part B premium. Each year the plan, not Medicare, decides what you pay for premiums, deductibles and services, and those amounts can change from year to year.

Getting Help Paying for Part B

If the premium is more than your budget can carry, you're not stuck. People with limited income and resources may be able to get help from their state to pay Medicare premiums and other costs. Brevy's Medicare Savings Programs guide, linked below, is a good place to start.

Frequently Asked Questions

Do I have to pay the Part B premium in a month I don't see a doctor?

Yes, and the amount isn't locked in either. The Part B premium is owed every month even when you use no Part B-covered services, and the premium amount can change each year.

Why was a doctor's visit during a hospital stay billed under Part B?

Because doctors' services are Part B's territory even inside a hospital. For someone who has Medicare Part B, Part B generally covers 80% of the Medicare-approved amount for doctors' services received while in a hospital.

How do I find out if Medicare Part B covers a specific test or service?

Look the service up at Medicare.gov/coverage, or call 1-800-MEDICARE (1-800-633-4227; TTY 1-877-486-2048) and ask.,

Do I need prior authorization for Part B services?

In Original Medicare, in most cases you don't need approval (prior authorization) for Medicare to cover services or supplies. Medicare Advantage plans are different and may require prior authorization for certain services or supplies.

Does 1-800-MEDICARE answer around the clock?

Medicare.gov says you can talk or live chat with a real person at 1-800-MEDICARE 24 hours a day, 7 days a week, except some federal holidays.

Learn More

MedicareWhat Is Medicare? Parts A, B, C, and D explainedWhat is Medicare? A plain guide to Parts A, B, C, and D, who qualifies, 2026 costs, when to enroll, and what it doesn't cover, with help-paying options. MedicareHow much Medicare costsHow much does Medicare cost in 2026? Part A, B, C, and D premiums, deductibles, and coinsurance, plus IRMAA and ways to lower your Medicare costs. MedicareIRMAA: the Medicare high-income premium surchargeIRMAA is the surcharge higher earners pay on Medicare Part B and Part D. See the 2026 brackets, the two-year income lag, and how to appeal with Form SSA-44. MedicareMedicare late enrollment penaltiesWorried you missed a Medicare deadline? Here is how the Part A, B, and D late enrollment penalties are calculated, how long each lasts, and how to avoid them. MedicareDo you have to sign up for Medicare at 65 if you're still working?Still working at 65? Whether you have to sign up for Medicare depends on your employer's size. Here's the 20-employee rule and how to delay Part B safely. MedicareMedicare Savings ProgramsMedicare Savings Programs help low-income enrollees pay Part B premiums and, with QMB, all cost-sharing. See the four MSPs, 2026 limits, and how to apply.

Find personalized help deciding when to sign up for Medicare Part B at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

Still have questions?

Brevy answers from this guide and every other guide here, and can check what you qualify for.

BC

Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.