Medicare has several parts, and it can be hard to tell what each one does. Understanding Medicare Part B matters because it is the part of Medicare that helps pay for many everyday medical needs outside a hospital, including doctor visits, outpatient care, medical equipment, and preventive services.
Quick answer: Medicare Part B is medical insurance. It helps cover medically necessary outpatient care and supplies, such as doctor services, outpatient hospital care, lab tests, durable medical equipment, certain home health services, and preventive services. Most people pay a monthly premium for Part B.
Medicare Part B is one half of Original Medicare
Original Medicare has two main parts:
- Part A is hospital insurance. It helps cover inpatient hospital care, skilled nursing facility care that meets Medicare requirements, hospice care, and some home health care.
- Part B is medical insurance. It helps cover many services and supplies you receive outside of an inpatient hospital stay.
Together, Part A and Part B make up Original Medicare. Part B is also important for people who choose to receive Medicare-covered benefits through a Medicare Advantage plan. In most cases, people in Medicare Advantage still pay the Part B premium, in addition to any plan premium that may apply.
What does Medicare Part B cover?
Part B helps pay for services that are medically necessary to diagnose or treat a condition, as well as many preventive services intended to help find health concerns early.
Common examples of Part B-covered care include:
- Visits with doctors and other qualified health care providers
- Outpatient hospital care, including many same-day procedures
- Laboratory tests, X-rays, and certain diagnostic tests
- Outpatient mental health services
- Ambulance transportation when Medicare coverage requirements are met
- Durable medical equipment, such as wheelchairs, walkers, hospital beds, oxygen equipment, and certain other supplies
- Certain home health services
- Physical therapy, occupational therapy, and speech-language pathology services when Medicare requirements are met
- Many preventive services, such as certain screenings, vaccines, and an annual wellness visit
Part B also covers some outpatient prescription drugs, especially drugs that are usually given in a doctor’s office or outpatient setting. However, most medicines you pick up at a retail pharmacy are generally covered under Medicare drug coverage, known as Part D, rather than Part B.
Coverage depends on Medicare rules and the details of the service. For example, a service may need to be medically necessary, ordered by an appropriate provider, or obtained from a provider or supplier that meets Medicare requirements.
What Part B generally does not cover
Part B does not pay for every health-related expense. Original Medicare generally does not cover most routine dental care, routine eye exams for glasses, hearing aids, routine foot care, cosmetic surgery, or long-term custodial care such as help with bathing or dressing when that is the only care needed.
There are exceptions and limited coverage rules for some services. For instance, Medicare may cover certain eye, dental, or foot services when they are connected to a covered medical condition or treatment. It is wise to check coverage before receiving a service that may not be routine.
What does Medicare Part B cost in 2026?
Medicare updates Part B costs each calendar year. For 2026, the standard Part B premium is $202.90 per month. The Part B annual deductible is $283.
After you meet the deductible, under Original Medicare you usually pay 20% of the Medicare-approved amount for many covered Part B services and items, as long as the provider accepts Medicare assignment. Assignment means the provider agrees to accept the Medicare-approved amount as full payment for the covered service.
Your actual cost can vary. It may depend on the service you receive, whether you have other insurance, the setting where you receive care, and whether your provider accepts assignment. Hospital outpatient care can involve separate facility charges in addition to professional services.
People with higher incomes may pay more than the standard premium. This is called an income-related monthly adjustment amount, or IRMAA. Social Security generally uses tax information from two years earlier to determine whether an IRMAA applies. If your income has gone down because of a qualifying life-changing event, you may be able to ask Social Security to reconsider the higher amount.
When should you enroll in Part B?
Many people become eligible for Medicare at age 65. Your Initial Enrollment Period generally begins three months before the month you turn 65, includes your birthday month, and ends three months afterward.
Some people are enrolled in Part A and Part B automatically, often because they are already receiving Social Security or Railroad Retirement Board benefits. Others need to actively sign up. Automatic enrollment and timing can vary, so review your Medicare information before you become eligible.
If you or your spouse has coverage from current employment, you may be able to delay Part B and use a Special Enrollment Period later. Whether that is appropriate depends on the size and type of employer coverage, among other details. Coverage from COBRA, retiree coverage, Marketplace coverage, VA benefits, or other sources may follow different rules and may not protect you from a Part B late enrollment penalty.
Can you be charged a Part B late enrollment penalty?
Possibly. If you do not enroll in Part B when first eligible and do not qualify for a Special Enrollment Period, you may have to pay a late enrollment penalty. The penalty is generally an extra 10% of the standard premium for each full 12-month period you could have had Part B but did not enroll.
For most people, the penalty lasts as long as they have Part B. It is not a one-time fee, and the dollar amount can change when the standard Part B premium changes.
Example: If someone went two full years without Part B after becoming eligible and did not qualify for a Special Enrollment Period, the penalty would generally be 20% of the standard premium. In 2026, 20% of the $202.90 standard premium is $40.58, which is rounded under Medicare rules. That person’s monthly Part B premium would be about $243.50 before considering any higher-income adjustment.
Enrollment decisions can be time-sensitive, especially for people leaving employer coverage. Medicare.gov and Social Security can provide official information about your enrollment window.
Help paying the Part B premium
If you have limited income and resources, you may be able to get help with Medicare costs through your state. Medicare Savings Programs can help pay Part A and Part B premiums and, depending on the program, may also help with deductibles, coinsurance, and copayments.
For example, the Qualified Medicare Beneficiary (QMB) Program can help pay Part B premiums and Medicare cost-sharing for covered services. The Specified Low-Income Medicare Beneficiary (SLMB) Program and the Qualifying Individual (QI) Program can help pay the Part B premium for people who qualify. States administer these programs, and eligibility rules can vary.
If you have full-benefit Medicaid along with Medicare, your state generally pays your Part B monthly premium. Depending on your Medicaid eligibility category and state rules, Medicaid may also help with other Medicare cost-sharing. Contact your state Medicaid agency for an eligibility decision.
What This Means for You
Part B is the portion of Medicare that supports much of your routine medical care outside a hospital. Before you decide when to enroll, confirm whether you already have creditable coverage from active employment, whether you qualify for a Special Enrollment Period, and what your expected costs may be.
It also helps to ask providers whether they accept Medicare assignment and to check whether a test, item, or service is covered before receiving care. If premium and out-of-pocket costs are difficult to manage, explore Medicaid and Medicare Savings Program assistance through your state.
Bottom Line
Medicare Part B is medical insurance that helps cover outpatient care, doctor services, preventive care, medical equipment, and other covered services. In 2026, the standard monthly premium is $202.90 and the annual deductible is $283. Enrollment timing matters because delaying Part B without qualifying coverage can lead to a coverage gap and a lasting late enrollment penalty.
Medicare rules, premiums, income thresholds, and costs can change. For official, current information, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227). Senior Healthcare Today is not affiliated with or endorsed by the U.S. government or the federal Medicare program. This content is provided for educational purposes only and is not intended to provide individual Medicare plan recommendations.