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Medicare Part B: Cost, Coverage and Eligibility
Medicare Part B covers medically necessary outpatient services and preventive care for people 65+ and those under 65 with a disability or specific health condition.
Elizabeth Aldrich is a writer at NerdWallet specializing in Medicare and other insurance topics including health, life, auto and homeowners insurance. She has been a financial journalist for 10 years, and her work has appeared in Forbes, Business Insider, CBS News, Bankrate, USA Today, CFP Board and Yahoo Finance. Prior to NerdWallet, she was a banking editor with expertise in Federal Reserve policy and produced studies that were cited by First Financial Bank and researchers at University of Chicago Law School and USC Gould School of Law. Elizabeth holds degrees in economics and philosophy from the University of Oregon. She is based in Portland, Oregon.
Alex Rosenberg is a NerdWallet writer specializing in Medicare and a range of other insurance topics including health, life, auto and homeowners insurance. He has more than 10 years of experience researching and writing about health care, insurance, public policy, technology and data privacy. His research has supported lawmakers in the Wisconsin State Legislature as well as health systems and national health authorities in the United States and more than 10 other countries.
Holly Carey is a managing editor at NerdWallet. She leads the Health Insurance team and supports other insurance topics including life, auto and homeowners. She joined NerdWallet in 2021 as an editor focused on expanding content to additional topics within personal finance. Previously, Holly wrote and edited content and developed digital media strategies as a public affairs officer for the U.S. Navy. She is based in Virginia Beach, Virginia.
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Medicare Part B overview
Medicare Part B is the medical insurance part of Medicare. It covers care you get at clinics and other outpatient locations. It's part of Original Medicare, along with Medicare Part A, which is hospital insurance. Click on the tabs below to learn more.
Doctor visits.
Outpatient services.
Home health care.
Durable medical equipment.
Vaccines.
Lab tests and screenings
Centers for Medicare & Medicaid Services. What Part B Covers. Accessed Jan 13, 2026.
. Most medically necessary services require a 20% Part B coinsurance, but you don’t pay anything for most preventive services.
Medicare Part B covers the following medically necessary services:
Doctor’s office visits, emergency room visits and specialist visits.
Outpatient hospital services like X-rays, stitches and casts.
Durable medical equipment like CPAP machines, lift chair mechanisms, wheelchairs, canes, walkers, diabetes supplies and hospital beds.
Ambulance services if traveling in any other vehicle could endanger your health.
Prescription drugs that have to be administered at a doctor's office or hospital. These can include infusions or injections. (Prescription drugs you take on your own are covered by Medicare Part D.)
Mental health services like therapy or counseling, psychiatric evaluations, medication management and partial hospitalization for mental health issues. (Part A covers mental health care if you’re admitted as an inpatient.)
Medicare Part B also covers the following preventive services
Screening colonoscopies (you may need to pay coinsurance for additional services like polyp removal or barium enemas).
Mammograms.
Certain preventive services are limited to certain sexes and/or have conditions on how often Medicare covers them. To pay nothing for some services, you need to get them from a health care provider that accepts Medicare assignment. Luckily, almost all do. You can find specific details for how individual services are covered at medicare.gov/coverage.
Shopping for Medicare plans? We have you covered.
Medicare Advantage is an alternative to traditional Medicare offered by private health insurers. It covers the same benefits as Medicare Part A and Part B.
UnitedHealthcare
4.11
CMS Star Rating
Average Medicare star rating, weighted by enrollment. Star ratings are determined by the Centers for Medicare & Medicaid Services (CMS).
We will connect you with Medicare companies based on the information you provide. They will help you find a plan that suits your needs. If you prefer to speak to a licensed insurance agent right away, please call the number listed.
We will connect you with Medicare companies based on the information you provide. They will help you find a plan that suits your needs. If you prefer to speak to a licensed insurance agent right away, please call the number listed.
Humana
3.79
CMS Star Rating
Average Medicare star rating, weighted by enrollment. Star ratings are determined by the Centers for Medicare & Medicaid Services (CMS).
We will connect you with Medicare companies based on the information you provide. They will help you find a plan that suits your needs. If you prefer to speak to a licensed insurance agent right away, please call the number listed.
We will connect you with Medicare companies based on the information you provide. They will help you find a plan that suits your needs. If you prefer to speak to a licensed insurance agent right away, please call the number listed.
There are some services Medicare Part B doesn’t cover. You’d be responsible for paying for these services out of pocket unless you have other insurance that covers them.
Here are a few examples of services not covered by Medicare Part B:
To see whether a Medicare Advantage plan will pay for some or all of your Part B premium, look for plans with “Part B premium reduction” or “Giveback” benefits.
Medicare Part B premiums for members with high income
People with high incomes may have to pay a higher Medicare Part B premium. This is known as the income-related monthly adjustment amount, or IRMAA. The government looks at your modified adjusted gross income from two years ago to determine whether you have to pay the IRMAA.
For 2026, beneficiaries whose 2024 income exceeded $109,000 (individual return) or $218,000 (joint return) will pay a premium amount ranging from $284.10 to $689.90, depending on income
Centers for Medicare & Medicaid Services. Costs. Accessed Jan 13, 2026.
See 2026 Medicare Part B IRMAA levels See 2026 Medicare Part B IRMAA levels
If your income in 2024 was this ...
You'll pay this each month in 2026
Individual tax return
Joint tax return
Married & separate tax return
Medicare Part B premium
Less than or equal to $109,000.
Less than or equal to $218,000.
Less than or equal to $109,000.
$202.90.
Greater than $109,000 and less than or equal to $137,000.
Greater than $218,000 and less than or equal to $274,000.
Not applicable.
$284.10.
Greater than $137,000 and less than or equal to $171,000.
Greater than $274,000 and less than or equal to $342,000.
Not applicable.
$405.80.
Greater than $171,000 and less than or equal to $205,000.
Greater than $342,000 and less than or equal to $410,000.
Not applicable.
$527.50.
Greater than $205,000 and less than $500,000.
Greater than $410,000 and less than $750,000.
Greater than $109,000 and less than $391,000.
$649.20.
Greater than or equal to $500,000.
Greater than or equal to $750,000.
Greater than or equal to $391,000.
$689.90.
See 2026 Medicare Part B IRMAA levels for immunosuppressive drug coverage only See 2026 Medicare Part B IRMAA levels for immunosuppressive drug coverage only
If your income in 2024 was this ...
You'll pay this each month in 2026
Individual tax return
Joint tax return
Married & separate tax return
Medicare Part B premium
Less than or equal to $109,000.
Less than or equal to $218,000.
Less than or equal to $109,000.
$121.60.
Greater than $109,000 and less than or equal to $137,000.
Greater than $218,000 and less than or equal to $274,000.
Not applicable.
$202.70.
Greater than $137,000 and less than or equal to $171,000.
Greater than $274,000 and less than or equal to $342,000.
Not applicable.
$324.30.
Greater than $171,000 and less than or equal to $205,000.
Greater than $342,000 and less than or equal to $410,000.
Not applicable.
$445.90.
Greater than $205,000 and less than $500,000.
Greater than $410,000 and less than $750,000.
Greater than $109,000 and less than $391,000.
$567.50.
Greater than or equal to $500,000.
Greater than or equal to $750,000.
Greater than or equal to $391,000.
$608.10.
Medicare Part B deductible
Medicare Part B comes with an annual deductible of $283 in 2026. You must pay this much each year before Medicare Part B starts to pay.
Medicare Part B coinsurance
After you meet the deductible for the year, you usually pay a 20% coinsurance for covered services. Medicare Part B pays the other 80%.
This is true if your provider accepts the amount Medicare agrees to pay for the service
. Some providers charge more than the Medicare-assigned amount. They may bill patients for the difference. Always ask a new health care provider if they accept the amount Medicare pays.
Many people on Original Medicare buy a Medigap plan. This supplemental insurance helps cover these out-of-pocket costs.
Most people start getting Medicare Part B at age 65. If you’re already receiving Social Security or Railroad Retirement Board benefits, you’ll be automatically enrolled in Original Medicare when you turn 65.
Everyone else must choose among these enrollment period options:
Initial enrollment period: This seven-month period starts three months before the month you turn 65. It includes your birthday month and ends three months after your birthday month. So if you turn 65 in July, you’ll have from April 1 to Oct. 31 to enroll.
Special enrollment period: This is when you’re allowed to join Medicare or make changes to your coverage based on specific life events. These include leaving a job or moving out of your plan’s coverage area.
General enrollment period: This period runs from Jan. 1 through March 31 every year. It's when people who already have Medicare can make limited changes to their coverage. It’s also when people who miss the deadline for initial enrollment can sign up.
Note: You still need to sign up for Medicare Part B if you’re receiving health care continuation coverage under COBRA. Otherwise, you’ll pay the Part B penalty. COBRA beneficiaries aren't eligible for the special enrollment period. In other words, COBRA isn't the same as if you were covered under a large employer health plan.
Medicare Part B late enrollment penalty
If you don't sign up for Part B when you become eligible at age 65 and later change your mind, you’ll pay a permanent late enrollment penalty. The penalty is an extra 10% above the standard premium cost for every 12-month period you delayed
💬 From our Nerds: Can you add Medicare Part B at any time?
“You should generally sign up for Part B during your initial enrollment period around your 65th birthday, unless you have group health insurance from an employer with 20 or more employees. Once that employer coverage ends, you have eight months to sign up for Part B.
“If you aren’t covered by qualifying group health insurance and you miss your enrollment windows, you may pay a late enrollment penalty for Part B — and you’ll pay it for as long as you have Part B.”
— Kate Ashford, lead writer covering Medicare
How does Medicare Part B work with employer insurance?
You can have both Medicare Part B and employer insurance at the same time, or you can delay enrolling in Part B.
If you decide to have both insurances, they work together to pay for your covered medical bills. If you decide to delay enrolling in Part B, you can avoid late enrollment penalties as long as:
You're covered by your or your spouse's employer-sponsored insurance.
The employer has 20 or more employees.
You sign up for Part B within eight months of your coverage ending.
You don’t have to do anything to delay enrollment, unless you’re already receiving Social Security or Railroad Retirement Board benefits before you turn 65. If this is the case, you’ll receive a Medicare card in the mail near your 65th birthday. Follow the instructions that come with the card. You can also call Social Security at 800-772-1213.
Do I need both Medicare Parts A and B? Do I need both Medicare Parts A and B?
You need both Medicare Part A and Part B to have both medical and hospital coverage. And you’ll need both if you want to buy a Medicare Advantage plan or a Medicare Part D prescription drug plan.
If you’re not eligible for premium-free Part A, you don’t have to buy it. You can buy Part B on its own. But if you sign up after your initial enrollment period, you may have to pay a late penalty.
Is Medicare Part B mandatory? Is Medicare Part B mandatory?
You’re not required to have Medicare Part B, although you must have Part A and Part B to buy a Medicare Advantage or Part D plan. If you wait too long to enroll in Part B after you’re eligible, you could pay a permanent late penalty.
Does everyone pay for Medicare Part B? Does everyone pay for Medicare Part B?
Medicare Part B has a premium of $202.90 per month in 2026. But if you have a low income and qualify for a Medicare Savings Program, you may be able to get help covering Part B costs. Some Medicare Advantage plans also cover a portion of the Part B premium.
Can I keep my doctor on Medicare Part B? Can I keep my doctor on Medicare Part B?
With Medicare Part B, you can see any health care provider who accepts Medicare and is taking new Medicare patients. You’ll want to ask your doctor if they can take you as a new Medicare patient.
That said, not all providers accept Medicare as full payment. Medicare classifies health care providers three ways:
Participating: They accept Medicare and Medicare-approved payment for services.
Nonparticipating: They accept Medicare but may charge more than Medicare’s approved payment.
Opt-out: They don’t accept Medicare at all. Patients are responsible for all costs, except for emergency or urgently-needed care.
Does Medicare Part B cover prescriptions? Does Medicare Part B cover prescriptions?
Medicare Part B covers some prescription drugs, but not the ones you get at the pharmacy. Part B’s coverage applies to drugs you get at a health care provider’s office, like a flu vaccine you get at your primary care physician.
Medicare Part B also covers some oral cancer drugs and medicines you’d have to use with durable medical equipment, such as nebulizer medications. And on rare occasions, Part B covers drugs you’re given in a hospital outpatient situation.
If you have additional questions about Medicare, visit Medicare.gov or call 800-MEDICARE (800-633-4227, TTY 877-486-2048).
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Medigap plan types the company generally offers (availability may vary by location). Options include Plans A, B, C, D, F, G, K, L, M and N.
NAIC complaint rate
How often the company’s members file complaints about their policies as compared to the industry average, according to data from the National Association of Insurance Commissioners (NAIC). NerdWallet conducts its data analysis and reaches conclusions independently and without the endorsement of the NAIC.
Premium discounts available
Based on the number and size of a company’s available discounts on monthly premiums, in comparison to other insurance companies.
We will match you with Medicare companies and offers based on the information you provide us. If you prefer to speak to a licensed insurance agent right away, please call the number listed above.
We will match you with Medicare companies and offers based on the information you provide us. If you prefer to speak to a licensed insurance agent right away, please call the number listed above.
We will match you with Medicare companies and offers based on the information you provide us. If you prefer to speak to a licensed insurance agent right away, please call the number listed above.
We will match you with Medicare companies and offers based on the information you provide us. If you prefer to speak to a licensed insurance agent right away, please call the number listed above.