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Medical Coverage

Medicare Part B
Medical Insurance

Part B covers outpatient medical services — doctor visits, preventive care, lab tests, imaging, and durable medical equipment. The standard 2026 premium is $185.00/month. Missing your enrollment window triggers a permanent 10% per-year penalty.

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$185Standard 2026 premium
Part BMedical Insurance
Medical Coverage

Medicare Part B — Medical Insurance

Part B covers outpatient medical services — doctor visits, preventive care, lab tests, imaging, and durable medical equipment. The standard 2026 premium is $185.00/month. Missing your enrollment window triggers a permanent 10% per-year penalty.

2025–2026 Cost Summary (Premium & Deductible are updated annually)

Standard Monthly Premium (2026)$185.00
Annual Deductible (2025–2026)$257
After DeductibleYou pay 20% of approved costs
Preventive Services$0 — 100% covered
Annual Wellness Visit$0 with enrolled provider
IRMAA SurchargeApplies if income >$106K/yr (2026)
Late Enrollment Penalty+10%/yr delayed — permanent
Age 65+ enrolled in Medicare Part A
Under 65 with qualifying disability (24 months SSDI)
Any age with ESRD or ALS
Still working with large employer? Penalty-free delay may apply — call us first
Doctor & specialist visits — any physician or specialist who accepts Medicare, nationwide
Preventive screenings — annual wellness visits, mammograms, colonoscopies, diabetes screenings, flu shots at $0
Outpatient surgery — same-day procedures that don't require overnight admission
Mental health care — outpatient psychotherapy, psychiatry, and counseling
Lab tests & diagnostic imaging — bloodwork, X-rays, MRIs, CT scans
Durable Medical Equipment — wheelchairs, walkers, CPAP machines, insulin pumps, prosthetics
Ambulance services — emergency medical transportation when clinically necessary
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FAQs

Common Questions About
Medicare Part B

What is the Part B late enrollment penalty?
Miss your window without qualifying employer coverage and you pay a permanent 10% surcharge per 12-month period delayed — forever. Delay 3 years = 30% higher premium for life.
Can I delay Part B if I'm still working?
Yes — if covered by a group plan from an employer with 20+ employees through your own active work. COBRA and retiree plans don't count. Always call us before making this decision.
What is IRMAA?
Higher-income beneficiaries pay a surcharge on Part B. In 2026 it applies above $106,000 individual income. If your income dropped due to retirement, you can file an appeal — we help navigate this.
Does Medigap cover the Part B 20% coinsurance?
Yes — Plan G covers Part B coinsurance after the $257 annual deductible. After meeting that, your Part B costs are effectively $0.
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