Medicare Part B in 2026: What It Costs and What It Covers

Medicare Part B is the piece of Original Medicare that most people interact with constantly — it covers your doctor visits, outpatient procedures, lab work, preventive screenings, durable medical equipment, and even some home health services. Yet despite how central it is to everyday healthcare, a surprising number of beneficiaries enroll without fully understanding what Part B actually costs them, what it does and doesn't cover, and how the government calculates their individual premium. Getting these details wrong can cost you thousands of dollars a year, or lock you into a permanent penalty that follows you for the rest of your Medicare life.

Let's start with the premium, because this is where confusion begins. In 2026, the standard monthly Part B premium is $185.00. That amount is automatically deducted from your Social Security check if you're already receiving benefits, which means many people never even see it leave their account — they just notice their Social Security deposit is smaller than expected. If you're not yet collecting Social Security, you'll receive a quarterly bill from Medicare and must pay it directly. The annual Part B deductible in 2026 is $257. Once you've met that deductible, Medicare pays 80% of the Medicare-approved amount for covered services, and you're responsible for the remaining 20% — with no annual cap on what that 20% can add up to.

That uncapped 20% coinsurance is one of the most important — and most underappreciated — features of Original Medicare. If you have a serious illness, a major surgery, or a prolonged hospital stay with extensive outpatient follow-up, your 20% share can climb into the tens of thousands of dollars. This is precisely why many beneficiaries pair Part B with either a Medicare Supplement (Medigap) plan or a Medicare Advantage plan. Medigap plans like Plan G, which is currently the most popular option for new enrollees, cover that 20% coinsurance entirely after you've paid your Part B deductible. Without some form of supplemental coverage, you're carrying open-ended financial exposure every time you use your Part B benefits.

Not everyone pays the same Part B premium, and this surprises many people who assumed Medicare was a flat-rate program. The federal government applies what's called an Income-Related Monthly Adjustment Amount, or IRMAA, to beneficiaries whose income exceeds certain thresholds. IRMAA is calculated based on your modified adjusted gross income (MAGI) from two years prior — so your 2026 premium is based on your 2024 tax return. In 2026, individuals with income above $106,000 (or married couples filing jointly above $212,000) begin paying IRMAA surcharges on top of the standard $185.00 premium. At the highest income tier — individuals earning above $500,000 or couples above $750,000 — the total monthly Part B premium reaches $628.90. If you've recently retired and your income has dropped significantly since the year used for your IRMAA calculation, you can appeal using Form SSA-44 to request a reduction based on a life-changing event such as retirement, divorce, or the death of a spouse.

Data Snapshot: According to CMS.gov data, approximately 67.5 million people were enrolled in Medicare as of 2024, with Part B enrollment accounting for the vast majority of that figure. CMS data also shows that the average Part B premium has risen steadily over the past decade, from $104.90 in 2014 to $185.00 in 2026 — a 76% increase over 12 years that underscores why understanding your premium trajectory matters for long-term retirement budgeting. CMS also reports that roughly 8% of Part B enrollees are subject to IRMAA surcharges in any given year, meaning the vast majority pay the standard rate — but for those who do face surcharges, the additional cost can be substantial and unexpected.

Part B coverage is broader than many people realize, but it also has clear boundaries. On the covered side, Part B pays for medically necessary services from physicians, nurse practitioners, physician assistants, and other qualified providers. It covers outpatient surgery, emergency room visits (the facility fee is covered under Part A, but physician services during that visit fall under Part B), mental health services, physical and occupational therapy, speech-language pathology, cardiac and pulmonary rehabilitation, and dialysis. It also covers a robust list of preventive services at no cost to you — meaning no deductible and no coinsurance — including the annual wellness visit, mammograms, colonoscopies, bone density scans, diabetes screenings, and certain vaccines including flu shots and the COVID-19 vaccine. Knowing which services are fully covered at zero cost-sharing can help you take advantage of preventive care without worrying about a bill.

Durable medical equipment — things like wheelchairs, walkers, hospital beds for home use, CPAP machines, and blood glucose monitors — is also covered under Part B, but with important caveats. The equipment must be deemed medically necessary by your doctor, and you must obtain it from a Medicare-enrolled supplier. If you purchase equipment from a supplier that doesn't accept Medicare assignment, you could face significantly higher out-of-pocket costs. For certain equipment categories, Medicare uses a competitive bidding program that designates specific suppliers in your area, and using an out-of-network supplier can mean Medicare won't pay at all. Always verify supplier participation before you order any durable medical equipment.

Part B does not cover everything outpatient, and knowing the gaps is just as important as knowing the coverage. Routine dental care, vision exams and eyeglasses (except following cataract surgery), hearing aids and routine hearing exams, and most cosmetic procedures are not covered under Part B. Prescription drugs administered in a doctor's office — like chemotherapy infusions or injectable biologics — are covered under Part B, but drugs you pick up at a pharmacy are covered under Part D, which is a separate program entirely. Long-term custodial care, such as help with bathing and dressing in a nursing home, is also not a Part B benefit. These gaps are significant, and beneficiaries who don't plan for them often face unexpected expenses in retirement.

Enrollment timing for Part B is one of the most consequential decisions you'll make, and the rules are stricter than most people expect. Your Initial Enrollment Period (IEP) spans seven months: the three months before your 65th birthday month, your birthday month itself, and the three months after. If you enroll during the first three months of your IEP, your coverage starts the first day of your birthday month. If you wait until your birthday month or after, your start date is delayed by one to three months. If you're still working at 65 and covered by an employer group health plan with 20 or more employees, you can delay Part B without penalty — but you must enroll within eight months of losing that employer coverage to avoid a late enrollment penalty. That penalty is a permanent 10% premium increase for every 12-month period you went without Part B when you were supposed to have it. On a $185 monthly premium, even a two-year delay adds $37 per month — permanently — to your cost.

The General Enrollment Period (GEP) runs from January 1 through March 31 each year and is available to people who missed their IEP and don't qualify for a Special Enrollment Period. Coverage obtained during the GEP begins July 1 of that year, meaning you could face a gap in coverage of several months. A Special Enrollment Period (SEP) is available when you lose qualifying employer coverage, and it gives you eight months to enroll without penalty. It's critical to understand that COBRA coverage and retiree health coverage do not count as the qualifying employer coverage that allows you to delay Part B — if you're relying on COBRA after leaving your job, you should enroll in Part B promptly to avoid a penalty.

For beneficiaries who are already enrolled in Part B and want to reduce their overall costs, there are several strategies worth exploring. First, make sure your providers accept Medicare assignment — meaning they agree to accept the Medicare-approved amount as payment in full. Providers who don't accept assignment can charge up to 15% above the Medicare-approved amount, which you'd owe out of pocket. Second, if your income has changed significantly, revisit your IRMAA status annually and appeal if warranted. Third, consider whether a Medicare Savings Program (MSP) applies to your situation — these state-administered programs help low-income beneficiaries pay Part B premiums, deductibles, and coinsurance, and in 2026 the income and asset limits for these programs are more generous than many people assume. The Qualified Medicare Beneficiary (QMB) program, for example, covers both Part A and Part B premiums for eligible individuals, and providers are prohibited from billing QMB enrollees for Medicare cost-sharing. Contact your State Health Insurance Assistance Program (SHIP) counselor — a free, unbiased resource available in every state — to find out if you qualify.

Understanding Part B is not a one-time exercise. Premiums, deductibles, and IRMAA thresholds are adjusted annually, typically announced by CMS each fall. Building a habit of reviewing your Medicare costs each October — when the Annual Enrollment Period also opens — puts you in the best position to make informed decisions about whether to stay in Original Medicare with a Medigap plan, switch to Medicare Advantage, or adjust your Part D drug coverage. The decisions you make about Part B ripple through every other part of your Medicare coverage, which is why getting a clear, accurate picture of what it costs and what it covers is the foundation of smart Medicare planning.