Medicare Part B covers the outpatient care most Americans over 65 rely on daily โ doctor visits, lab tests, preventive screenings, and durable medical equipment. The 2026 standard monthly premium is $185.00, up from $174.70 in 2025.
If you're budgeting for retirement, that's $2,220 per year before any IRMAA surcharges. Here's everything you need to know.
2026 Part B at a Glance
- Standard premium: $185.00/month
- Annual deductible: $257
- Coinsurance after deductible: 20% of Medicare-approved amount
- IRMAA threshold starts at: $106,000 (individual) / $212,000 (joint)
- Late enrollment penalty: 10% per 12-month period you delayed
Bottom line: If your 2024 income was above $106,000, you'll pay more than $185/month. Check your IRMAA bracket now โ it's based on a two-year lookback.
What Part B Actually Covers
Part B splits into two buckets: medically necessary services and preventive care.
Medically necessary (you pay 20% after deductible):
- Doctor office visits
- Outpatient surgery
- Mental health services
- Ambulance transport
- Durable medical equipment (wheelchairs, oxygen)
Preventive care (usually $0 cost to you):
- Annual Wellness Visit
- Mammograms, colonoscopies
- Flu, COVID, and pneumonia vaccines
- Diabetes screenings
2026 IRMAA Brackets โ Who Pays More
IRMAA (Income-Related Monthly Adjustment Amount) is a surcharge on top of the standard premium. Medicare uses your 2024 tax return to set your 2026 rate.
| 2024 Individual MAGI | 2024 Joint MAGI | 2026 Monthly Premium |
|---|---|---|
| Up to $106,000 | Up to $212,000 | $185.00 |
| $106,001โ$133,000 | $212,001โ$266,000 | $259.00 |
| $133,001โ$167,000 | $266,001โ$334,000 | $370.00 |
| $167,001โ$200,000 | $334,001โ$400,000 | $480.90 |
| $200,001โ$500,000 | $400,001โ$750,000 | $591.90 |
| Above $500,000 | Above $750,000 | $628.90 |
If you had a major income event in 2024 (home sale, Roth conversion, retirement distribution), expect the surcharge. You can appeal an IRMAA determination if your income dropped significantly in 2025 โ use SSA Form SSA-44.
The Enrollment Windows You Cannot Miss
Initial Enrollment Period (IEP): Starts 3 months before your 65th birthday month, ends 3 months after. Miss this and late penalties apply.
Special Enrollment Period (SEP): If you have employer coverage when you turn 65, you get 8 months after that coverage ends โ no penalty.
General Enrollment Period (GEP): January 1 โ March 31 each year, but coverage starts July 1 and the late penalty applies.
Bottom line: Don't assume your employer coverage counts as "having Medicare." The rules for COBRA and retiree coverage are different โ confirm with Medicare before your IEP closes.
Review 2026 Part B Costs on Medicare.govOfficial Medicare cost tables and coverage details โ
How Part B Premiums Are Deducted
Most people don't write a check. If you receive Social Security, Part B is automatically deducted from your monthly benefit โ so your net deposit is already reduced.
If you don't yet receive Social Security, you're billed quarterly by Medicare. Set up auto-pay to avoid any lapse in coverage.
Lowering Your Part B Costs
Three legitimate paths to reduce what you pay:
- Medicare Savings Programs (MSPs): State-funded programs that pay your Part B premium if your income and assets are below state thresholds. Roughly 1 in 3 eligible people never apply. Check your state Medicaid office.
- Extra Help / Low Income Subsidy (LIS): Primarily targets Part D, but qualifying can also trigger MSP eligibility.
- IRMAA appeal (SSA-44): If your 2024 income was unusually high due to a one-time event, file SSA-44 to use a more recent tax year.
The Late Enrollment Penalty Compounds โ Fast
Miss your Initial Enrollment Period and you'll pay 10% extra on your Part B premium for every 12-month period you went without coverage. That's a permanent penalty, not a one-time fee.
Example: Wait two full years past your IEP and your base premium becomes $185.00 ร 1.20 = $222.00/month โ for life. Over 20 years of retirement, that's an extra $8,880 paid in penalties.
The penalty clock is unforgiving. If you're approaching 65 and unsure whether your current health coverage qualifies as a valid delay reason, call 1-800-MEDICARE now.
The $185 Number Is Just the Start
Part B is one layer of a four-part system. Most people pair it with either a Medigap (supplement) policy or a Medicare Advantage (Part C) plan to cap their 20% coinsurance exposure.
Without a supplement, a serious illness can generate thousands in out-of-pocket costs โ the 20% coinsurance has no annual cap under original Medicare. A 30-day hospital stay, chemotherapy, or major surgery can produce five-figure out-of-pocket costs under Part B alone.
Compare your options each year during Open Enrollment (October 15 โ December 7). Your premium, deductible, and drug coverage can all change year to year.
Medigap Plan G is currently the most popular supplement for new enrollees โ it covers all Part B excess charges and coinsurance after the annual deductible. Shop plans at medicare.gov/plan-compare.
