Key takeaways:
Medicare Part B is the part of original Medicare that covers outpatient services and some medications not covered by Medicare Part A hospital insurance or Part D prescription plans.
You may have to pay a monthly penalty if you don’t sign up for Part B when you’re first eligible.
Your monthly premium for Medicare Part B depends on your income.
If you're turning 65 and considering Medicare coverage, you may be eligible to enroll in both Part A hospital insurance and Part B for outpatient services. These two parts, known as original Medicare, collectively provide basic healthcare coverage.
Medicare Part A covers hospital care, while Part B covers medical services received in an outpatient setting. While most people do not pay a premium for Part A, Part B requires a monthly payment, and there are rules about when you can enroll.
What is Medicare Part B?
Medicare Part B is an optional program that’s part of original Medicare and helps cover the cost of outpatient services. These services include regular checkups with your healthcare professional, lab tests, and certain medications.
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You automatically qualify for Medicare Part B if you’re eligible for premium-free Part A. However, if you have to pay a premium for Part A, there are certain requirements you must meet to be eligible for Part B.
What does Medicare Part B cover?
Medicare Part B covers a range of medically necessary and preventive services.
Medically necessary services and supplies
Medically necessary services and supplies are those that are used to diagnose and treat a medical condition. Some examples of medically necessary services commonly covered by Part B are:
Visits with a healthcare professional
In addition to other medically necessary supplies, Part B covers certain types of durable medical equipment, such as:
Preventive services
Preventive services help prevent conditions or diagnose illnesses at an early stage, when treatment is most beneficial. Some preventive services covered under Part B are:
List of medications covered by Medicare Part B
Medicare Part B typically only covers medications that are given in a healthcare professional’s office or in another outpatient setting, such as:
Medications used with medical equipment like infusion pumps or nebulizers
Antigens
Erythropoiesis-stimulating agents for people with end-stage renal disease or anemia related to other conditions
Medications for end-stage renal disease that are taken by mouth
Blood-clotting factors for people with hemophilia
Vaccines for flu, pneumococcal pneumonia, hepatitis B, and more
Transplant or immunosuppressive medications, in certain cases
As of January 1, 2023, individuals whose full Medicare coverage ends 36 months after a kidney transplant can choose to continue Part B coverage for immunosuppressive medications by paying a premium — as long as they don’t have other qualifying insurance.
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Typically, you can expect to pay 20% of the Medicare-approved amount for medications covered under Part B. This is after you’ve paid your Part B deductible, which is $283 in 2026.
What is not covered by Medicare Part B?
Medicare Part B does not cover:
Routine dental care
Routine vision care
Routine physical exams, though annual wellness visits are covered
You can use the Medicare coverage query tool to check if a specific test or item is covered under Medicare Part B.
How much is Medicare Part B?
Your monthly premium amount for Medicare Part B depends on your income. The income thresholds and set premium amounts are subject to change every year.
Medicare Part B premiums for 2026
The 2026 standard premium for Medicare Part B is $202.90 per month. According to the Centers for Medicare & Medicaid Services, most people will pay this amount. To qualify for the standard premium in 2026, individual earners had to have reported a 2024 income of $109,000 or less — or $218,000 or less for joint filers.
In general, what you pay in Part B premiums depends on the modified adjusted gross income shown on your tax return. Those who earn more money pay more in premiums, which is known as the income-related monthly adjustment amount (IRMAA). The IRMAA has five payment levels above the standard monthly premium, with the max premium being $689.90 per month in 2026 for the tax filers who report $500,000 or more income individually or $750,000-plus jointly.
For some people, Part B monthly premiums are automatically deducted from Social Security or Railroad Retirement Board benefits. If you don’t get these benefits, you’ll get a bill for your premiums every 3 months that you can pay online, directly from your checking or savings account, or by mail.
To find out when you’ll likely be eligible for Medicare or to get an estimate of how much you can expect to pay in premiums, use the Medicare eligibility and premium tool.
Medicare Part B deductible and coinsurance
Unlike your Medicare Part B premiums, your Part B deductible isn’t based on your income. For 2026, the Medicare Part B deductible is $283 for all enrollees.
After you meet your Part B deductible, you will typically pay 20% of the Medicare-approved amount for:
Most outpatient visits
Outpatient therapy
Durable medical equipment such as blood sugar meters, oxygen equipment, and walkers
Medicare Part B enrollments
Failing to apply for Medicare Part B when you’re first eligible could cost you later. Here’s a guide on how to enroll in Medicare Part B on time to make sure you don’t face any penalties.
Initial enrollment period
When you first become eligible for Medicare at age 65, you have a 7-month initial enrollment period to apply for Part B. This window to enroll begins 3 months before you turn 65 and lasts for 3 months after your birthday month. So, for example, if your 65th birthday is in June, your initial enrollment period begins in March (3 months before your birthday) and lasts until September (3 months after your birthday).
Late-enrollment penalty
If you sign up for Part B after your initial enrollment period, you’ll be charged a late-enrollment penalty of 10% for each 12-month period you could have had Part B. That means: The longer you go without Part B, the higher the penalty. However, you will not pay the penalty if you meet certain special enrollment period requirements.
Special enrollment period
If you miss your initial enrollment period, there are certain situations that may qualify you for a special enrollment period. This is a limited window outside of the general enrollment period during which you can enroll in Part B without facing a late-enrollment penalty. You can learn more about how to sign up for a special enrollment period on the Medicare basic information site. Special enrollment periods are assessed individually on a case-by-case basis.
The following situations may qualify you for a special enrollment period for Medicare Part B and Part A:
Losing Medicaid coverage
Moving back to the U.S. after living abroad
Leaving a facility, such as a nursing home or rehabilitation hospital, where you were previously staying
Losing employer-sponsored or union health coverage, including COBRA coverage
Qualifying for Extra Help to assist with Medicare prescription medication coverage costs
Receiving incorrect or misleading information from a representative of Medicare or a Medicare plan that leads to your enrollment in a plan
General enrollment period
If you didn’t sign up for Medicare Part B during your initial enrollment period and you don’t qualify for a special enrollment period, you’ll have to wait for the next general enrollment period. And you may have to pay a monthly late-enrollment penalty once you sign up.
General enrollment runs from January 1 to March 31 annually. (Note that this differs from Medicare's annual open enrollment period in the fall.) You can sign up for Medicare Part B during general enrollment if one of these situations applies to you:
You didn’t enroll in Medicare Part B when you were first eligible.
You canceled Part B without having other insurance but would like to enroll again.
You didn’t enroll for Part B within 8 months of no longer working or your employer-sponsored or union health plan ending (whichever happened first).
If you apply for Medicare Part B between January 1 and March 31, your coverage will start the month after you sign up. You can enroll in Medicare online, by fax, or by mail.
Medicare Part B additional resources
In addition to Medicare.gov, here are a few other sources for Medicare-related information:
Medicare Rights Center: The Medicare Rights Center is a nonprofit organization that helps people who are covered by Medicare understand their rights and how the system works. Call their free national hotline at 1-800-333-4114 or visit www.medicareinteractive.org for assistance.
Center for Medicare Advocacy: This nonprofit advocacy organization promotes health equity and access to quality healthcare for people who have Medicare. The Center for Medicare Advocacy offers free resources, like self-help checklists, to assist you in appealing a Medicare denial.
State Health Insurance Assistance Program (SHIP): A SHIP offers free, unbiased counseling and assistance programs for every state, Washington, D.C., and some territories. To find information about your local SHIP office, call 1-877-839-2675.
Frequently asked questions
Medicare Part A primarily covers inpatient hospital care and certain types of care after hospitalization. Most people don’t pay premiums for Part A if they or their spouse paid Medicare payroll taxes for at least 10 years.
Medicare Part B covers outpatient care such as physician visits, preventive services, and certain types of medical equipment. Part B has a monthly premium, which varies based on income.
Enrolling in Medicare Part B is optional, however, you might face penalties for not enrolling when you first become eligible. If you don't have insurance through an employer or other creditable source, you may want to enroll in Part B when you first become eligible to avoid these penalties.
Without Part B, you could face significant out-of-pocket expenses for necessary medical services. Additionally, if you delay signing up for Part B and don’t have other coverage, you could face a gap in coverage and a late-enrollment penalty in the future.
Medicare Part A primarily covers inpatient hospital care and certain types of care after hospitalization. Most people don’t pay premiums for Part A if they or their spouse paid Medicare payroll taxes for at least 10 years.
Medicare Part B covers outpatient care such as physician visits, preventive services, and certain types of medical equipment. Part B has a monthly premium, which varies based on income.
Enrolling in Medicare Part B is optional, however, you might face penalties for not enrolling when you first become eligible. If you don't have insurance through an employer or other creditable source, you may want to enroll in Part B when you first become eligible to avoid these penalties.
Without Part B, you could face significant out-of-pocket expenses for necessary medical services. Additionally, if you delay signing up for Part B and don’t have other coverage, you could face a gap in coverage and a late-enrollment penalty in the future.
The bottom line
Medicare Part B typically covers medications delivered in a healthcare professional’s office or outpatient setting. It also covers a range of medically necessary services and some preventive care services.
You may want to delay signing up for Medicare Part B if you currently have health insurance that offers you the coverage you need. But remember, you may have to pay a monthly penalty down the line if you don’t sign up for Part B when you’re first eligible.
Be mindful of the enrollment periods for Medicare Part B to ensure you don’t miss out on the opportunity to sign up and avoid late-enrollment penalties. Visit www.medicare.gov or call 1-800-633-4227 to learn more.
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References
Center for Medicare Advocacy. (n.d.). Self help materials.
Centers for Medicare & Medicaid Services. (2025). 2026 Medicare Parts A & B premiums and deductibles.
Centers for Medicare & Medicaid Services. (2026). Original Medicare (Part A and B) eligibility and enrollment.
Medicare.gov. (n.d.). Avoid late enrollment penalties.
Medicare.gov. (n.d.). Coronavirus disease 2019 (COVID-19) vaccine.
Medicare.gov. (n.d.). Durable medical equipment (DME) coverage.
Medicare.gov. (n.d.). Estimate my Medicare eligibility and premium.
Medicare.gov. (n.d.). Get started with Medicare.
Medicare.gov. (n.d.). How to drop Part A and Part B.
Medicare.gov. (n.d.). Incontinence supplies and adult diapers.
Medicare.gov. (n.d.). Prescription drugs (outpatient).
Medicare.gov. (n.d.). Preventative and screening services.
Medicare.gov. (n.d.). Special enrollment periods.
Medicare.gov. (n.d.). What Part B covers.
Medicare.gov. (n.d.). When does Medicare coverage start?
Medicare.gov. (n.d.). Yearly “wellness” visits.
U.S. Social Security Administration. (n.d.). Sign up for Medicare.
