Medicare Part B
Understand outpatient medical coverage, premiums, enrollment timing, and late-enrollment exposure.
Services and preventive care
Part B helps pay for medically necessary doctor visits, outpatient hospital care, certain durable medical equipment and many preventive services. A service may still have frequency, setting or provider requirements. The yearly Wellness visit is a preventive benefit; separately performed tests or treatment at the same appointment may create additional charges. Verify the actual service and Medicare coverage rule, not simply the name of the visit.
Official source: Medicare: Part B coverage ↗
2026 premium and deductible
For most beneficiaries the standard Part B premium is $202.90 a month in 2026 and the Original Medicare annual Part B deductible is $283. Higher income can add IRMAA, and a late-enrollment penalty may also increase the premium. Once the Original Medicare deductible applies, many Part B services leave 20% of the Medicare-approved amount to the beneficiary when the provider accepts assignment. Advantage plans use plan-specific cost sharing instead.
Official source: Medicare: 2026 costs ↗ · Medicare: Original versus Advantage ↗
Avoid an avoidable enrollment gap
A typical first enrollment window spans the three months before the 65th birthday month, that month and three months after. Someone covered through current employment may qualify for a Part B Special Enrollment Period. COBRA and retiree coverage do not extend that current-employment window; the ordinary eight-month clock begins when employment or qualifying coverage ends, whichever occurs first. SSA handles Part B applications and employer evidence.
Official source: Medicare: When coverage starts ↗ · Medicare: Working past 65 ↗ · SSA: Sign up for Part B only ↗
What a late penalty measures
Without an applicable exception, Medicare generally increases the Part B premium by 10% for each full 12-month period you could have had Part B but did not enroll. Medicare’s example of a 24-month delay produces a 20% increase; the penalty generally continues while you have Part B. Do not calculate this from an assumed start date: verify first eligibility, qualifying employer coverage and agency records.
Official source: Medicare: Avoid penalties ↗ · SSA: Sign up for Part B only ↗
After enrollment
Keep your Part B effective date and premium notice. Before a doctor visit, verify the provider’s Medicare participation under Original Medicare, or exact plan-network participation if you chose Advantage. Ask separately about referral or prior-approval requirements and the service’s cost sharing. A Part B card alone does not establish that a particular Advantage plan provider is in network.
Official source: Medicare: Part B coverage ↗ · Medicare: Medicare Advantage guide ↗