Medicare Part B: Costs, Coverage & What You Pay

What Does Medicare Part B Cover?

Part B covers medically necessary doctor and medical services, outpatient care, and preventive services.

Generally, if Medicare-covered care is provided by a doctor or in an outpatient setting, it falls under Part B rather than Part A.

What Doesn't Medicare Part B Cover?

A few gaps trip people up more than any others:

• Most prescription drugs you take at home — that's Part D's job
• Routine dental care
• Routine vision care — exams, glasses, contacts
• Hearing aids and routine hearing exams
• Long-term custodial care
• Most care received outside the United States
• A routine annual physical (Part B covers a wellness visit instead — more on that in the FAQ)

How Much Does Medicare Part B Cost in 2026?

Most people pay the standard $202.90 monthly premium.

Higher earners pay more through IRMAA, based on income from two years earlier. See current Part B costs at Medicare.gov.

A one-time high-income year — a Roth conversion, a home sale — can bump your premium two years later, since IRMAA looks backward.

What Do You Actually Pay When You Use Part B?

This is the part most people underestimate.

Once you've met the $283 deductible, Medicare pays 80% of the approved amount for most services.

You pay the remaining 20%.

Say Medicare approves $200 for an outpatient service after you've hit your deductible.

Medicare pays $160. You pay $40.

Now stretch that across a year of specialist visits, imaging, and procedures — and remember, there's no ceiling on it.

*Assumes the Part B deductible has already been met and standard 20% coinsurance applies.

Who Is Eligible for Part B?

Age-based: You're 65 or older and a U.S. citizen, or a legal permanent resident who's lived here at least five continuous years.

Disability-based: You qualify before 65 after 24 consecutive months on SSDI, with End-Stage Renal Disease requiring dialysis or a transplant, or with ALS.

Part B starts the same month your disability benefits begin. See eligibility details at Medicare.gov.

When Should You Enroll in Part B?

Initial Enrollment Period

You get 7 months: 3 before your 65th birthday, your birthday month, and 3 after.

Enroll in the first 3 months and coverage starts the month you turn 65.

Enroll during your birthday month or the 3 months after, and coverage generally starts the month after you sign up.

General Enrollment Period

Missed your window and don't qualify for a Special Enrollment Period? You can enroll between January 1 and March 31.

Coverage generally starts the first day of the month after you enroll — not the following July, which is outdated guidance you may still see repeated elsewhere.

See current enrollment timing at Medicare.gov.

You may also owe a late enrollment penalty if you went without qualifying employer coverage in the meantime.

Special Enrollment Period

If you have qualifying group health coverage based on your or your spouse's current employment, you can generally delay Part B and enroll later through a Special Enrollment Period.

That period generally ends 8 months after your employment or group health coverage ends, whichever comes first.

Do You Need Part B If You're Still Working?

Not necessarily — but this is where we see people make the most expensive mistake on this whole topic.

If you or your spouse has qualifying group health coverage based on current employment, you may be able to delay Part B without a late enrollment penalty.

But don't make that decision based on "I'm still working" alone.

Employer size and how your group plan coordinates with Medicare matter.

For many people working for an employer with 20 or more employees, the employer plan pays first.

With smaller employers, Medicare may be primary, which can make enrolling in Part B at 65 important.

Confirm how your employer coverage works before delaying Part B.

What Happens If You Delay Part B?

Without a qualifying SEP, delaying past your Initial Enrollment Period usually means a permanent late enrollment penalty.

That's 10% added to your premium for every full 12-month period you were eligible but didn't enroll.

That penalty doesn't expire — it rides on your premium for as long as you have Part B.

You'll also generally have to wait for the next General Enrollment Period to get coverage, which can mean months without Part B in the meantime.

How Does Medigap Help With Part B Costs?

Since Part B leaves that 20% coinsurance uncapped, this is exactly the gap a Medicare Supplement plan is built to close.

There's also a high-deductible version of Plan G.

In 2026, you pay Medicare-covered deductibles, copays, and coinsurance up to the plan's $2,950 deductible before the Medigap policy begins paying.

See our Plan G vs. High Deductible Plan G comparison if that trade-off interests you.

Plan G and Plan N aren't the only options — see our full Medicare Supplement plans comparison chart to see how every plan letter stacks up.

How Do You Pay the Part B Premium?

Already collecting Social Security or Railroad Retirement benefits? Your premium is deducted automatically from your check — nothing to do.

Not collecting Social Security or Railroad Retirement benefits yet?

If you pay Medicare directly for Part B, you'll generally receive a Medicare Premium Bill (Form CMS-500).

You can pay it online at medicare.gov, through free Medicare Easy Pay bank deduction, by mail, or through your own bank's bill pay.

Miss a payment and Medicare sends a second bill.

Miss that one too, and you risk losing coverage — worth setting up Easy Pay if you're not on automatic deduction already.

Can You Cancel Medicare Part B?

Yes, but it takes more than a phone call.

You'll need Form CMS-1763 from the Social Security Administration, and in most cases a personal interview confirming you understand what you're giving up.

Before you do this: dropping Part B can mean a lifetime late enrollment penalty later, and it can affect your Medigap or Medicare Advantage eligibility too.

FAQ