Medicare Part B: Medical Insurance, explained clearly.
Part B covers doctor visits, outpatient care, preventive services, durable medical equipment, and medically necessary treatments. May River Medicare is a nationwide independent agency — we show you the coverage, the real 2026 costs, and how to avoid the penalties, before you ever speak to anyone.
Figures below reflect the official 2026 amounts set by CMS.
Three things to understand first
It’s your outpatient coverage
Part B pays for doctor visits, specialists, outpatient surgery, lab work, and most care you get without being admitted to a hospital.
The 80/20 split
After your deductible, Medicare pays 80% of approved charges and you pay the other 20% — and there’s no cap on that 20%.
There’s a monthly premium
Most people pay the standard premium. Higher earners pay more through an income adjustment called IRMAA.
The care you use most
Doctors & Diagnostics
- Primary care & specialist visits
- Lab work & imaging
- Outpatient procedures
Preventive Services
- Flu shots & vaccines
- Mammograms & colonoscopies
- Heart & diabetes screenings
Clinical Treatments
- Chemotherapy & radiation
- Dialysis
- Infused medications
Medical Equipment
- Oxygen & CPAP
- Wheelchairs & walkers
- Hospital beds & supplies
What Medicare Part B actually costs in 2026
Unlike Part A, the Part B deductible is annual — it resets every January 1. After you meet it, Medicare pays 80% of approved costs and you pay 20%, with no yearly out-of-pocket maximum under Original Medicare.
| Part B cost (2026) | What you pay |
|---|---|
| Standard monthly premium | $202.90 / mo |
| Annual deductible | $283 / year |
| After deductible (coinsurance) | 20% of approved cost |
| Annual out-of-pocket maximum (Original Medicare) | None |
| Higher-income premium (IRMAA) | Above $202.90 |
That 20% coinsurance has no annual cap under Original Medicare. A single $50,000 outpatient surgery could leave you owing roughly $10,000 after the deductible. This is the exact gap a Medicare Supplement (Medigap) or Medicare Advantage plan is built to close — and the reason most people don’t stay on Part A and B alone.
Higher-income beneficiaries pay an Income-Related Monthly Adjustment Amount on top of the standard premium. It’s based on your tax return from two years prior — so your 2026 premium looks at your 2024 income. If your income dropped due to a life event (retirement, loss of a spouse), you can appeal it. We can walk you through that.
Getting Part B — and getting the timing right
Automatic enrollment
If you’re already receiving Social Security at 65, you’re usually enrolled in Part B automatically — your card arrives in the mail.
Manual enrollment
If it isn’t automatic, you apply through Social Security online, by phone, or in person. Timing matters — we’ll make sure you enroll in the right window.
The Part B late enrollment penalty is permanent
If you delay Part B without other creditable coverage, your premium goes up 10% for every full 12-month period you could have had it but didn’t — and that higher premium lasts for the rest of your life. If you’re still working with employer coverage, the rules are different and you may be able to delay penalty-free. This is exactly the kind of timing question we help you get right, at no cost.
Get expert help with Medicare Part B — free.
Understand your medical costs, avoid the lifetime penalty, and protect yourself from that unlimited 20% exposure with the right supplement or Advantage plan. If your income is limited, Medicare Savings Programs may even cover your Part B premium.
Compare plans, talk to a licensed advisor, or get started online in minutes.
May River Medicare Insurance is an independent agency and is not affiliated with or endorsed by the U.S. government, the federal Medicare program, or CMS. Cost figures reflect 2026 amounts published by CMS and are for educational purposes; your actual costs may vary. For a complete list of your options, contact Medicare.gov or 1-800-MEDICARE.