Part B — Medical Insurance
Medicare Part B covers doctor visits, outpatient care, preventive services, and durable medical equipment. The standard 2026 premium is $202.90/month, but varies with income.
What Part B Covers
Part B is your outpatient and medical insurance — everything outside a hospital stay.
Doctor Visits & Specialist Care
Office visits, specialist consultations, and surgeries performed on an outpatient basis. You pay 20% of the Medicare-approved amount after meeting your deductible.
Preventive Services
Annual wellness visits, flu shots, pneumococcal vaccines, mammograms, colonoscopies, diabetes screenings, cardiovascular disease screenings — most are covered at no cost to you.
Outpatient Hospital Care
Emergency room visits, outpatient surgeries, and observation stays. Note: observation stays are billed under Part B, not Part A, even if you stay overnight.
Mental Health Services
Outpatient psychiatry, psychotherapy, and counseling. Part B covers 80% of approved costs after the deductible.
Durable Medical Equipment (DME)
Wheelchairs, walkers, hospital beds, oxygen equipment, blood sugar monitors, and other equipment deemed medically necessary by your doctor.
Ambulance Services
Covered when other transportation could endanger your health. Medicare pays 80% of the approved amount after your deductible.
Part B Costs (2026)
You pay a monthly premium for Part B regardless of whether you use services that month.
| Cost Type | Amount |
|---|---|
| Standard monthly premium | $202.90 |
| Annual deductible | $257 |
| Coinsurance after deductible | 20% |
| Outpatient mental health | 20% |
| Preventive services | $0 |
Income-Related Adjustment (IRMAA)
If your modified adjusted gross income (MAGI) from 2 years ago exceeded certain thresholds, you pay a higher Part B premium. This is called IRMAA (Income-Related Monthly Adjustment Amount).
| Annual Income (Individual / Couple) | Monthly Part B Premium |
|---|---|
| $106,000 or less ($212,000 for couples) | $202.90 |
| $106,001–$133,000 ($212,001–$266,000) | $259.00 |
| $133,001–$167,000 ($266,001–$334,000) | $370.00 |
| $167,001–$200,000 ($334,001–$400,000) | $480.90 |
| $200,001–$500,000 ($400,001–$750,000) | $591.90 |
| Above $500,000 (above $750,000 for couples) | $628.90 |
Based on 2023 tax return income. Thresholds adjust annually.
How to Enroll in Part B
Most people are automatically enrolled — but some need to sign up manually.
Automatic Enrollment
If you're already receiving Social Security benefits when you turn 65, you're automatically enrolled in both Part A and Part B. Your Medicare card arrives in the mail about 3 months before your 65th birthday.
Manual Enrollment
If you're not receiving Social Security (e.g., still working, delayed benefits), you need to sign up for Part B through Social Security during your Initial Enrollment Period (7-month window around your 65th birthday).
Sign Up at SSA.govPart B Late Enrollment Penalty
The Penalty
For each 12-month period you were eligible for Part B but didn't enroll, your premium increases permanently by 10%. If you waited 3 years, you pay 30% more — forever.
Exception: Employer Coverage
If you delayed Part B because you had qualifying employer coverage (active, from your own job or your spouse's), you get a Special Enrollment Period with no penalty when that coverage ends.
Explore Other Medicare Parts
Get Your Free Medicare Quote
A licensed NJ Medicare advisor will explain your Part B options and find plans that minimize your out-of-pocket costs.