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The standard Medicare Part B premium is $202.90 per month in 2026, and the annual deductible is $283. Most beneficiaries pay the standard premium, but higher-income enrollees can pay as much as $689.90 per month through IRMAA. After the deductible, you usually pay 20% of the Medicare-approved amount for covered Part B services under Original Medicare, although some services use different cost-sharing rules.
CMS increased the standard premium from $185 in 2025 to $202.90 in 2026 and raised the deductible from $257 to $283.
Key takeaways
- 2026 standard Part B premium: $202.90 per month.
- 2026 Part B deductible: $283 for the year.
- Typical coinsurance: Usually 20% of the Medicare-approved amount after the deductible for many Part B services.
- No annual out-of-pocket maximum: Original Medicare itself has no yearly cap on what you can spend out of pocket.
- 2026 IRMAA starts above $109,000 of 2024 MAGI for individual filers or $218,000 for married couples filing jointly.
- Highest 2026 Part B premium: $689.90 per month for beneficiaries in the top IRMAA bracket.
- Part B covers doctor services, outpatient care, durable medical equipment, certain home health services, mental health treatment, preventive services, and some outpatient drugs.
- Original Medicare generally does not cover routine dental care, routine eye exams for glasses, hearing aids, long-term custodial care, or most retail prescription drugs.
How much does Medicare Part B cost in 2026?
CMS set the following standard Part B costs for 2026:
| Cost | 2025 | 2026 | Increase |
|---|---|---|---|
| Standard monthly premium | $185.00 | $202.90 | $17.90/month |
| Annual deductible | $257 | $283 | $26/year |
The premium alone costs $2,434.80 over 12 months if you pay the standard $202.90 rate all year.
That does not include the deductible, coinsurance, prescription drug coverage, Medigap premiums, Medicare Advantage premiums, or services that Medicare does not cover.
CMS says the 2026 Part B increase was driven mainly by projected healthcare price changes and expected increases in utilization.
How does the $283 Part B deductible work?
For many Part B services, you pay Medicare-approved costs until you have satisfied the $283 annual deductible.
After that, you usually pay 20% of the Medicare-approved amount, assuming the provider accepts Medicare assignment.
A simplified example:
Suppose you receive a Medicare-covered service with a Medicare-approved amount of $500 after you have already met your deductible.
- Medicare generally pays $400.
- You generally pay $100.
But the 20% rule does not apply identically to every Part B service.
For example, Medicare says you usually pay $0 for covered clinical laboratory tests, and many preventive services have no deductible or coinsurance when the provider accepts assignment. Hospital outpatient services may also involve separate copayments.
So think of 20% as the common Part B cost-sharing rule, not a rule that applies to every single claim.
Does Original Medicare have an out-of-pocket maximum?
No.
This is one of the biggest financial gaps in Original Medicare.
There is no annual limit on what you can spend out of pocket under Original Medicare alone for Part A and Part B-covered services.
If you have repeated specialist visits, outpatient procedures, chemotherapy, durable medical equipment, or other expensive Part B care, that 20% share can become significant.
This is one reason many Original Medicare beneficiaries consider Medigap, which can pay some of the deductibles, copayments, and coinsurance left by Original Medicare.
Medicare Advantage works differently. Medicare Advantage plans have an annual out-of-pocket limit for covered Medicare services, although premiums, networks, copays, prior authorization rules, and maximums vary by plan. You must also continue paying your Part B premium while enrolled in Medicare Advantage.
For a full comparison, see our Medicare Advantage vs Original Medicare guide.
What does Medicare Part B cover?
Medicare describes Part B as medical insurance.
It primarily covers two categories:
- Medically necessary services used to diagnose or treat a medical condition.
- Preventive services designed to prevent illness or detect problems earlier.
Common Part B-covered services include:
- doctor and specialist visits
- outpatient hospital care
- outpatient surgery
- medically necessary ambulance services
- durable medical equipment
- physical and occupational therapy
- mental health and substance-use treatment
- diagnostic laboratory testing
- certain home health services
- dialysis
- some medications administered in a doctor’s office or outpatient setting
- many preventive screenings and vaccines
Coverage still depends on Medicare’s rules for the specific service, including whether it is medically necessary and whether frequency or eligibility requirements apply.
Does Part B cover doctor visits?
Yes.
Part B covers medically necessary services from doctors and other eligible healthcare professionals, including many primary-care and specialist visits.
After the deductible, you generally pay 20% of the Medicare-approved amount for covered provider services.
Your cost can be different if the provider does not accept assignment, the service takes place in a hospital outpatient setting, you have supplemental insurance, or the service is subject to a special Medicare cost rule.
Does Part B cover preventive care for free?
Many preventive services are available without cost-sharing, but not every preventive-related visit or test is automatically free.
Medicare says you pay nothing for most preventive services when you receive them from a provider who accepts assignment.
Examples can include certain:
- vaccines
- cancer screenings
- cardiovascular screenings
- diabetes screenings
- preventive counseling services
- the “Welcome to Medicare” preventive visit
- yearly Wellness visits
But there is an important catch.
If your provider performs additional diagnostic tests or other services during a preventive visit, the Part B deductible and coinsurance can apply to those additional services.
For example, Medicare’s yearly Wellness visit has no charge when your provider accepts assignment. But if the provider performs additional services that are not included in the preventive benefit, you may owe deductible or coinsurance.
The Annual Wellness Visit is not a physical
Medicare’s yearly Wellness visit is designed to create or update a personalized prevention plan.
It is not the same thing as a traditional annual physical exam. Medicare specifically lists routine physical exams among services Original Medicare generally does not cover.
That distinction catches a lot of new beneficiaries by surprise.
Does Medicare Part B cover lab work?
Yes, when Medicare’s coverage requirements are met.
Part B covers medically necessary diagnostic laboratory tests ordered by a healthcare provider.
For Medicare-covered clinical laboratory tests, you usually pay nothing.
This is another reason the simple “Part B pays 80%, you pay 20%” explanation is incomplete.
Does Part B cover mental health care?
Yes.
Part B covers qualifying outpatient mental health and substance-use services, including services from eligible mental health professionals.
Depending on the service, normal Part B deductible and coinsurance rules can apply.
Medicare also covers certain preventive mental health services, such as depression screening, under separate preventive-service rules.
Does Medicare Part B cover home health care?
Part B can cover qualifying home health services, but you do not need a prior qualifying hospital stay simply to qualify for Medicare home health coverage.
That requirement is often confused with rules involving skilled nursing facility care.
To qualify for Medicare-covered home health services, you generally must need part-time or intermittent skilled care, meet Medicare’s homebound requirements, receive an appropriate provider assessment and order, and use a Medicare-certified home health agency.
Medicare says you pay $0 for covered home health services. If you need Medicare-covered durable medical equipment as part of your home care, the usual Part B deductible and 20% coinsurance can apply to the equipment.
Medicare does not generally pay for 24-hour home care, meal delivery, homemaker services unrelated to the medical care plan, or custodial personal care when that is the only care you need.
Does Part B cover prescription drugs?
Only certain drugs.
Part B covers a limited group of outpatient medications, including some drugs administered by doctors or other healthcare professionals and certain drugs connected with durable medical equipment.
For most prescriptions you pick up at a retail pharmacy, you generally need Medicare Part D or prescription drug coverage through a Medicare Advantage plan.
So it is more accurate to say:
Part B covers some outpatient drugs. Part D handles most ordinary prescription-drug coverage.
What does Medicare Part B not cover?
Original Medicare has important gaps.
It generally does not cover:
- routine dental care, including most cleanings, fillings, dentures, and implants
- routine eye exams for prescription glasses or contacts
- hearing aids and exams for fitting hearing aids
- long-term custodial care
- routine physical exams
- cosmetic surgery
- most care received outside the United States
- most ordinary retail prescription drugs
There are exceptions.
For example, Medicare can cover specific dental services when they are directly related to certain Medicare-covered medical treatments, including some organ transplant, cancer-treatment, heart-valve, and dialysis situations.
Similarly, Medicare can cover some medically necessary eye care even though routine vision exams are excluded.
Do not interpret “Medicare doesn’t cover dental or vision” as meaning that no medically necessary dental- or eye-related service can ever be covered.
What are the 2026 Medicare Part B IRMAA brackets?
Higher-income beneficiaries pay more than the $202.90 standard Part B premium.
The additional charge is called the Income-Related Monthly Adjustment Amount, or IRMAA.
For 2026, Social Security generally uses income information from your 2024 federal tax return to determine whether IRMAA applies. MAGI for this purpose generally consists of adjusted gross income plus tax-exempt interest income.
2026 Part B IRMAA rates
| 2024 MAGI, individual filer | 2024 MAGI, married filing jointly | 2026 monthly Part B premium |
|---|---|---|
| $109,000 or less | $218,000 or less | $202.90 |
| Over $109,000 to $137,000 | Over $218,000 to $274,000 | $284.10 |
| Over $137,000 to $171,000 | Over $274,000 to $342,000 | $405.80 |
| Over $171,000 to $205,000 | Over $342,000 to $410,000 | $527.50 |
| Over $205,000 but below $500,000 | Over $410,000 but below $750,000 | $649.20 |
| $500,000 or more | $750,000 or more | $689.90 |
These are the official 2026 full Part B premium amounts published by CMS.
The original $106,000 and $212,000 thresholds were the 2025 thresholds, not 2026.
What about married filing separately?
A special IRMAA table applies when you file married filing separately and lived with your spouse at some point during the tax year.
For 2026:
| 2024 MAGI | 2026 monthly Part B premium |
|---|---|
| $109,000 or less | $202.90 |
| Over $109,000 but below $391,000 | $649.20 |
| $391,000 or more | $689.90 |
Different treatment can apply if spouses lived apart for the entire tax year.
What if your income has fallen since 2024?
IRMAA can feel especially frustrating if you had high income in 2024 but retired or experienced another major income reduction afterward.
Social Security allows beneficiaries to request a new IRMAA determination after certain life-changing events.
Examples can include retirement or work stoppage, work reduction, marriage, divorce, death of a spouse, and certain losses of income-producing property or employer settlements.
SSA Form SSA-44 is used for many of these requests.
Do not assume you have to pay a 2026 IRMAA based on an old salary without checking whether your change qualifies for reconsideration.
Why did Medicare Part B increase in 2026?
The standard premium rose 9.7%, from $185 to $202.90 per month.
CMS says the increase in the 2026 premium and deductible was mainly caused by expected healthcare price changes and increases in utilization consistent with historical experience.
CMS also says policy changes involving skin-substitute payments reduced what otherwise would have been an even larger increase.
That is more precise than saying the increase simply came from “new drugs and treatments.”
Part A vs Part B: what is the difference?
Part A and Part B together make up Original Medicare.
| Medicare Part A | Medicare Part B |
|---|---|
| Primarily hospital insurance | Primarily medical insurance |
| Inpatient hospital care | Doctor and specialist services |
| Qualifying skilled nursing facility care | Outpatient care |
| Hospice | Preventive services |
| Certain home health care | Durable medical equipment |
| Usually premium-free for eligible workers | Usually has a monthly premium |
Most people receive premium-free Part A because they or a spouse paid Medicare taxes long enough while working. Medicare says this generally means at least 10 years of Medicare-taxed work.
Part B is different. Most beneficiaries pay the standard monthly premium, although IRMAA, late-enrollment penalties, or assistance programs can change what an individual actually pays.
What if you cannot afford the $202.90 Part B premium?
Do not assume you have to drop Part B.
Medicare Savings Programs can help eligible people with limited income and resources pay Medicare costs. Depending on the program, assistance can include the Part B premium and, in some cases, deductibles, coinsurance, and copayments.
Eligibility rules and income treatment can vary, so check through Medicare or your state Medicaid program if the Part B premium is difficult to afford.
This can be much more valuable than simply delaying or dropping Part B and risking coverage gaps or penalties.
What happens if you enroll in Part B late?
If you do not enroll when first eligible and do not qualify for a Special Enrollment Period or another exception, you may owe a permanent Part B late-enrollment penalty.
Medicare generally increases the premium by 10% for each full 12-month period you could have had Part B but did not enroll.
For example, someone who delayed Part B for two full years without qualifying for an exception would generally face a 20% penalty.
Using the 2026 standard premium:
$202.90 × 20% = $40.58
The resulting 2026 premium would be rounded to $243.50 per month in Medicare’s example.
The Part B penalty generally lasts for as long as you have Part B.
However, delaying Part B does not automatically create a penalty. Special Enrollment Period rules can protect people who delay enrollment because they have qualifying coverage through current employment.
Do not assume any employer insurance is sufficient. Confirm the Medicare enrollment rules for your specific coverage before delaying Part B.
FAQ
What is the Medicare Part B premium for 2026?
The standard Medicare Part B premium is $202.90 per month in 2026, up from $185 in 2025. Higher-income beneficiaries pay more through IRMAA.
What is the Medicare Part B deductible for 2026?
The annual Part B deductible is $283 in 2026, up from $257 in 2025. Some Part B services, including many preventive services and covered clinical laboratory tests, are not subject to the normal deductible rules.
Does Medicare Part B pay 80% of everything?
No. Medicare generally pays 80% of the Medicare-approved amount for many Part B services after the deductible, leaving you with 20%. But some services have different rules. Covered clinical laboratory tests usually cost $0, many preventive services have no cost-sharing, and hospital outpatient services can involve copayments.
What income triggers IRMAA in 2026?
For 2026, IRMAA generally starts when 2024 MAGI exceeds $109,000 for an individual filer or $218,000 for married couples filing jointly.
What is the highest Medicare Part B premium in 2026?
The highest standard full Part B premium with IRMAA is $689.90 per month in 2026. It applies at $500,000 or more of MAGI for individual filers and $750,000 or more for married couples filing jointly.
Does Medicare Part B cover dental?
Not routine dental care in most cases. Original Medicare generally does not cover cleanings, fillings, dentures, implants, or routine extractions. It can cover certain dental services when they are directly connected with specific Medicare-covered medical treatments.
Does Medicare Part B cover an annual physical?
Part B covers a yearly Wellness visit, but Medicare specifically says that this is not a routine physical exam. Routine physicals are generally not covered by Original Medicare.
Does Medicare Part B cover prescription drugs?
Part B covers certain outpatient medications, including some drugs administered in a clinical setting. Most retail prescription drugs are instead covered through Medicare Part D or a Medicare Advantage plan with drug coverage.
Does Medicare Part B have an out-of-pocket maximum?
Original Medicare does not have an annual out-of-pocket maximum. Supplemental coverage such as Medigap can help pay some Original Medicare cost-sharing, while Medicare Advantage plans have annual limits for covered Medicare services.
How do I appeal Medicare IRMAA after retirement?
If a qualifying life-changing event reduced your income, you can ask Social Security to reconsider IRMAA. SSA Form SSA-44 is used for many life-changing-event requests.
Bottom line
Medicare Part B costs $202.90 per month for most beneficiaries in 2026, with a $283 annual deductible.
But $202.90 is only the starting point for understanding your real healthcare cost.
Under Original Medicare, you usually pay 20% of the Medicare-approved amount for many Part B services after meeting the deductible, and there is no annual out-of-pocket maximum. That makes supplemental coverage and your expected healthcare use important parts of the decision.
Higher-income beneficiaries should also check the correct 2026 IRMAA thresholds. IRMAA begins above $109,000 of 2024 MAGI for individual filers and $218,000 for married couples filing jointly, with the highest Part B premium reaching $689.90 per month.
Part B covers far more than routine doctor visits, including outpatient treatment, mental health services, certain home health care, durable medical equipment, preventive care, and some medications. But it still leaves significant gaps, including most routine dental, vision, hearing, long-term custodial care, and retail prescription drugs.
For the next decision, see our Medicare Advantage vs Original Medicare guide. If you are reviewing coverage during the fall enrollment period, see our Medicare Open Enrollment 2026 guide.
This article is for educational and informational purposes only and is not medical, insurance, tax, legal, or financial advice. Medicare premiums, IRMAA thresholds, coverage rules, and individual costs can change. Verify your own coverage and costs through Medicare.gov, CMS, or Social Security before making enrollment or coverage decisions.
